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Jedi's aid bags and general musings

Discussion in 'First Aid Station' started by Jedi5150, Dec 5, 2018.

  1. Jedi5150

    Jedi5150 Empty Pockets

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    Hello all, I just posted an intro in the new member section, but figured I would start a thread here since the medical side of EDC is kind of my area of interest. I thought it would be fun to share some of the stuff I carry and use, how I organize my gear, and also to get tips and feedback from all you folks as well. I'm hoping this will be less of an article on how I do things, and more of a format to generate good discussion on the topic of aid bags and their contents. It's something of a passion for me. From what I've already read on this site, I know there are some very knowledgeable folks here, and I'd love to get some ideas floating around.

    A little about me, I've been on a wilderness SAR team for 20 years now, the first three of which were as a volunteer and the rest have been in a paid capacity. I've also done one form of public safety or another (worn quite a few hats) for about 24 years, but EMS has always been a part of that. There are folks on this forum who have far more medical knowledge than me, so I want to put that out there front and center. The highest level of medical certification I've obtained is primarily BLS (Basic Life Support, for the benefit of our non-medical folks), aside from a few ALS certs over the years. I also need to mention that I can't take any credit for the cool tips or ideas I'll share, I stole them all from much more knowledgeable people than I. I particularly need to give a shout out to Emmett Spraktes, an SSG with the CA National Guard, Silver Star recipient, and author of the book, "Selfish Prayer". I've been to more "tactical medic" courses over the years than I can count, ranging from 8 hour to two week classes, and Emmett's class I recently took was frankly outstanding. Highly recommended (and no, I get nothing for saying it, he probably has no idea who I am...hahaha).

    So enough introduction, here goes:

    A few months back I decided I needed to put together a small aid bag for the front seat of my car, while at work. Although I have a nice large aid bag in the back of my vehicle, I can't always get to it as fast as I need it. My criteria for the new kit was it had to hold a fair bit more than a traditional IFAK, but be smaller and handier than a true aid bag. Space in the front seat is at a premium. It also had to have straps so I could sling it when I jumped out of the car, and preferably a detachable sling, for reasons I'll explain in a minute. I came across the Mystery Ranch "VLAK" (Vehicle Litter Aid Kit), and decided it would fit the role nicely. It was the first Mystery Ranch product I'd owned, but I had always heard good things about their quality. I should also mention that I debated putting this in the "gear review" subforum, but truth be told, this thread is way more about what goes in the kit, than the container itself. The VLAK is advertised as holding double the amount of a typical IFAK, which made it pretty close to perfect for my needs.

    Here it is, from the outside (and on a side note, some of the photos I took with my DSLR, but most I have to apologize for as being cell phone pics I snapped tonight):
    [​IMG]

    It has PALS webbing and straps covering the back, so it can be mounted on a larger pack, or on a MOLLE panel in a vehicle, if that's your thing. It also has two straps with quick release buckles on the top, so you can add a rolled up pole-less litter. The shoulder sling has a quick release buckle at each end, which is a big deal for me, and here is why; From time to time at work, on the kind of incident where I would need to grab an aid bag, I'll also likely have a carbine or less-lethal shotgun slung, as well as a plate carrier in some cases. All of that can start to become webbing spaghetti, and taking an aid bag off or accessing it quickly can be a real challenge, depending on the order the rest of your gear was donned. The quick release buckles for the sling have proven their worth in real world use for me, and I now consider them to be sort of indispensable.

    [​IMG]

    When you pop open the VLAK, the front panel stays closed and you can access it like a traditional top-opening haversack. Or, you can rip down the front panel and the whole thing flops open like a flayed fish. Although I've never had the two side-zippers inadvertently open on their own, kind of a neat feature is that the paracord draws for the zippers are the perfect length to link through each other, which prevents them from accidently opening, until you manually pull them apart. I don't know if that is a design feature, or just fortunate coincidence. Either way, I like it.

    Here it is, all opened up:
    [​IMG]

    And, proof that the contents don't explode when you open it, even if it's still slung on you or an object (this part takes some work):
    [​IMG]

    The VLAK comes with a slot pocket on one "wing", a mesh slot pocket on the main body, and assorted elastic webbing elsewhere. Here I have some minor complaints: The elastic webbing used is either too stiff, in the case of the large straps, or too thin and long, in the case of the smaller ones, for my taste. I'm also not infatuated with where they chose to mount the elastic webbing. For instance, on the right "wing", they put the elastic very low on the front of the slot pocket, which makes the items you put in the webbing not really secure. I wanted to mention these deficiencies, because in spite of how much I love the VLAK, and I truly do love it, it does have room for improvement. That said, the VLAK has been so incredibly effective for me (I've used it 3 times in as many months, on serious incidents), even with it's flaws, I still don't think there is anything out there that would suit my needs better. And for a gear-nut like me, that's high praise.

    Now let's get to the meat and potatoes, the contents:

    [​IMG]

    Here's a list of what I carry in the VLAK:
    -Nitryl gloves (x4 pair)
    -Tourniquets (x2...one CAT and one SOFT-TW)
    -NPA (28Fr w/lube)
    -OPA (90mm)
    -Laerdal pocket mask
    -HyFin Vent chest seals (x2)
    -Cravat
    -Space blanket
    -Ace wrap (3")
    -Trauma shears (dummy-corded to pack)
    -Forcepts
    -Chemlight
    -Hemostatic gauze (x2...currently one Celox Rapid and one Combat Gauze)
    -Israeli bandage (x2...one 6" and one 4")
    -Gauze sponges (2x2" and 4x4", with two saline bullets)
    -Normal Saline (100ml bottle, for wound irrigation/ cleaning)
    -Iodine (in a dropper bottle)
    -Minor medication pack (Excedrin, Aspirin, Ibuprofin, Bendaryl, Immodium, etc.)
    -Minor boo boo pack (bandaids, moleskin, etc.)
    -TCCC patient information card
    -Sharpie
    -Durapore cloth tape (2" roll)
    -Narcan (4mg nasal spray)
    -14ga catheter
    -Duct tape (small roll)
    -Contact lens case

    And finally, the organization:
    [​IMG]

    Anything that isn't water/ blood proof, or anything that can spill, I have in a Ziploc bag. Aid kits get nasty inside with blood, you also want to avoid stuff getting waterlogged, so baggies help in both regards. Tourniquets are obviously removed from wrappers and "pre-rigged". With the Ace wrap, and Israeli bandages (at least one), I subscribe to the "clean, not sterile" mindset; For anyone who has opened an Israeli bandage under stress, they will back me up when I say, it's a pain. They come double wrapped, with foil on the outside and vacuum pack plastic on the inside. It can be tough to find the pre-cut notches, especially with gloves on, at night, and in the rain or with bloody hands. The first thing that the ER staff are going to do with the trauma patient is give them a nice big IV dose of antibiotics. Add this to the fact that nothing in the pre-hospital setting will be "sterile"...it's not an operating room, for Pete's sake. So with the Israeli (or similar) bandage in a Ziploc bag, you just rip it open under stress (gross motor skill), and you're instantly to treating your patient.

    [​IMG]

    On items like chest seals or hemostatic gauze, where the contents will spoil once opened, I pre-rig those by putting duct tape "tabs" next to the factory cut notches, so they are quick to find, even blindfolded and gloved up. The key is that using an aid kit doesn't usually happen in ideal circumstances. You can't guarantee good lighting conditions, clean surfaces, etc. So getting all your gear set-up to work in the cruddy situations, makes you exponentially more effective. That's also the reason for the chemlight. In a large aid bag I recommend an actual headlamp (backed up with chemlights), but for a kit this size, the chemlight makes more sense. Tape rolls should have the end doubled over on itself to make a tab, etc. Anything you can do to make life easier for yourself when it goes sideways will help.

    If you have the room, keep in mind any personal medications/ equipment that might come in handy. My contact lens case is an example of this. Anyone who wears them can attest to just how debilitating eye problems can be with a broken contact or debris in your eyes if you wear contacts. Moleskin and immodium are other examples of things everyone may not need, but could come in very useful for some kits, such as mine, where wilderness SAR is a possible scenario.

    I should also address the 14ga catheter, since it's a hot topic. It will be a personal judgement call for everyone, but even though I am a BLS care provider, I still carry 14ga catheters for pleural decompression. Not for myself to use (although I have been trained to, and done it on cadavers), but for any ALS providers who might be present, and without enough supplies of their own.

    Anyways, thanks for bearing with me through the wall of text. I'd love to hear comments, questions, and feedback on what works for you folks. I will add more to this thread down the road, such as a discussion on my large aid bag.

    -Jedi
     
    Last edited by Jedi5150, Dec 5, 2018
    #1 Jedi5150, Dec 5, 2018
    Last edited: Dec 5, 2018
  2. thegrouch314

    thegrouch314 Loaded Pockets

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    This has to be one of the best and most well thought kits I've ever seen. It's clear that you've put your experience to good use in designing this. I really like the pack too, might have to pick one of those up.

    The only thing I'd add would be more gloves and a head lamp. I don't know if you carry a headlamp elsewhere nearby but I like to carry one attached to my FAKs. I also carry at least 6 pairs of gloves, 3 pairs in a small (what I wear) and 3+ XL for anyone who might be assisting.
    Admittedly, I'm not a medic and only have limited first aid training so I'll defer to your experience.
     
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  3. JHGM

    JHGM Dinosaur Supervisor

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    Excellent kit!



    Only thing I would add (change really) is your saline...

    I've found that the eyewash containers work well for irrigation since they are squeeze type with a small nozzle on top.

    Great for getting the crud out of smaller wounds.

    This pack is definitely going on my wish list!

    Thanx for the detailed post.

    ...and thanx for reminding me that I STILL need to add a space blanket to my EDC trauma kit.
     
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  4. Jedi5150

    Jedi5150 Empty Pockets

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    Thanks grouch, I appreciate it! And you make good points. You can never have too many gloves. I could definitely squeeze in another pair or two, and it wouldn't hurt. As for the headlamp, I went with just a chemlight for this kit, due to almost being at max capacity. But a headlamp is definitely more effective, and truth be told, I could still squeeze one in there. I will seriously consider it. I can always use an excuse to get another headlamp regardless. :D
     
  5. Jedi5150

    Jedi5150 Empty Pockets

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    Thanks JHGM, glad you liked it. The space blanket I think gets overlooked in a lot of kits for a number of reasons...most people don't have as many lying around as they do other supplies, and they definitely aren't as cool or sexy as some of the other gear that goes in the kits. But with how much MARCH has been pounded into us recently, it's been a good reminder to use space blankets. A lot of "field saves" are later dying in the ICU a couple days later because the trauma patient was only treated for trauma, and not hypothermia.

    Your eye wash idea is outstanding. I wonder if a contact solution bottle with a nozzle would work as well? They would both have a lot of benefits, such as way easier to use without just dumping it out, more precise, and easier to carry bottles in general. I know it's basically still saline, but do you know if any of their other ingredients would be contraindicated for major wounds? If not, that's something I'd absolutely switch to.
     
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  6. ArkansasFan30

    ArkansasFan30 Loaded Pockets

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    I like the bag and admire your SAR skills. I'd love to become a proficient tracker and backwoods navigator.

    Many years ago, I was a park ranger and scheduled to attend a SARTECH II course for a week. Amusingly enough, it was cancelled due to bad weather. I left a year later and went to grad school.

    There was a time (just shy of ten years) I carried around a bunch of medical junk around in my private vehicle, and used to be certified as a paramedic, but I never once used it. I stumbled across some broken necks and a few broken limbs but never found anything I felt the need to tend to as an ad hoc first responder. I keep gear for myself and family now and am more concerned about being ambushed or run over as an ad hoc (private citizen) first responder/helper.
     
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  7. ffmedic245

    ffmedic245 Loaded Pockets

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    Add a cheapo penlight. You can't check pupil reaction with a glowstick. Personally I'd add a second cutting device as well. You carried out the "2-is-1" theory well with TQs and Israelis, I'd make sure you have a backup there too.

    Finally, be careful with the 14ga and check your local laws.
     
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  8. Jedi5150

    Jedi5150 Empty Pockets

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    Thanks ArkansasFan! I wish I could say I'm skilled at tracking, but unfortunately I'm not. I was a K9 handler for 6 years, and my pup was a tracking machine (he's retired now), but I never got good at man-tracking myself. Some of our volunteers are excellent at it. Land Nav I'm not too shabby at though.
     
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  9. Jedi5150

    Jedi5150 Empty Pockets

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    A penlight is a great idea, thanks. In most situations where I'd be using this kit I would have other cutting tools on me as well, so I'm kind of undecided on having a back-up pair of shears or a small pocket knife in this particular kit. In my big aid bag in the car I carry two pairs of shears (one on the outside and one inside), but this kit has to be a bit of a compromise in regards to the amount of stuff I can have in it.

    As for the 14ga, I've had some discussions with our county Medical Director, and he doesn't have an issue with us carrying them in our blow-out kits, but he is of course adamant that only ALS providers can actually use them, which is a policy I agree with (and would follow even if I didn't). But your point is well taken, folks should always look into stuff like that ahead of time. Many IFAKs are sold with 14ga catheters and hemostatic gauze, and it's on the end-user to make sure they know whether those are even allowed or not. I had to check our county protocols to make sure hemostatic agents were allowed, because for many years, they weren't.
     
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  10. JHGM

    JHGM Dinosaur Supervisor

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    The type I carry is 100% sterilized water so no issue there.
     
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  11. TJones

    TJones Empty Pockets

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    Quality post mate. Loving the idea of putting some duct tape extension on pull tabs. Will be doing that with my kit first thing tomorrow morning.

    Do you not carry any observation stuff like SpO2 meter, thermometer, etc.?

    Sent from my Pixel 2 XL using Tapatalk
     
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  12. Jedi5150

    Jedi5150 Empty Pockets

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    Thanks TJones, glad you liked it.

    This kit is specifically for rapid trauma/ extraction type stuff. I carry a much larger aid bag in the back of my car that has a BP cuff, stethoscope, etc. Although in that, I don't currently have either a thermometer or SP02 meter. I've thought about getting a pulse ox, but then I've also read conflicting reviews on them; I guess a lot of people question their accuracy on trauma patients, since someone in shock, or hypothermic, will be shunting blood from the extremities, and will make the device give an inaccurate reading. Still, they aren't that expensive, so I may end up getting one for my large bag.

    As a side note, I will be updating this post with a review of my big bag as well, I just haven't gotten around to it yet.
     
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  13. TJones

    TJones Empty Pockets

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    I find having a pulse ox quite useful as an indicator of circulation if there's a break involved in arms or legs, and it's a great way to check pulse without having to time and do mental arithmetic. Most seem accurate these days but as long as you're thinking with your brain and not blindly trusting the readings they're great little things to have considering their small form factor.

    Definitely get your big back up

    Sent from my Pixel 2 XL using Tapatalk
     
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