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Notes on Medical Gear and Immediate Action Medical

Discussion in 'First Aid Station' started by CBRNE, Jul 5, 2016.

  1. CBRNE

    CBRNE Loaded Pockets

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    I am new to this forum. I have been looking around a little and notice a lot of questions and concerns regarding various medical gear topics.

    I am an operational medic that specializes in HAZMAT/CBRN medicine. I work with a very specific group of professionals in a brach of the US State Department. I travel OCONUS often, and often work in remote/austere environments for short durations. This requires me to adapt conventional ideals for unconventional environments.

    Blow-Out Vs. Boo-Boo: The OPMED paradox

    1: If you do not have the gear on your person, you do not have it at all.
    2: Blow-out gear is meant to mitigate problems that will kill you in 5 minutes or less
    3: Boo-Boo gear is meant for everything else
    4: They should never mingle; keep the bandaids separate from the trauma dressings, you do not want to have to dig through a metric ton of aspirin and ointment when you have vital fluids leaking from a new hole at an alarming rate
    5: You DO get what you pay for, RATS TQs have been proven inferior to windlass-style TQs. Spend the money and get a SOF-T Wide, your limb will thank you.
    6: Under Critical Stress, fingers become flippers, and blood is really slippery. Keep that in mind when you place your kit. Tape all your fingers together, cover them with mineral oil and try to access your gear, that is a realistic exercise.
    7: Do NOT attach your blowout pouch to your back, or anywhere else that it is not immediately accessible by BOTH hands. If you get your dominant arm blown off, good luck reaching your kit with your off-hand. Place the gear front-and-center. I personally carry 2-3 blow out kits on my tactical gear; 1 right in the middle of my chest, 1 at 11o'clock on my belt and another somewhere in my pants.
    8: DO NOT rely on ANYONE else being there when you receive holes. Self-aid BEFORE buddy aid.
    9: Two is one, one is none. Examine wound patterns from active shooter incidents/IED attacks; bi-lateral (both sides) leg injuries are very common. If you only carry 1 TQ, have the hard conversation with your legs as to which one you love more.
    10: Use YOUR gear on YOU. Use THEIR gear on THEM. If they do not have gear, consider being a nice guy and carrying enough for them, but SEGREGATE YOURS from EVERYONE ELSES.

    When it comes to boo-boo gear, be creative. Do you really need 17 different sized bandaids and 4 different size dressings? If you are mending an injury that requires this gear, you are not (or definitely should not be) in a time or operational constraint, IE you have all the time in the world. Carry 4x4s, roll gauze, steri-strips, 2" tape and a rubber chicken. You can fix pretty much anything short of a life-threatening laceration with those items. You can omit the rubber chicken if you wish. If you are fixing holes anywhere other than an OR, you are not in a sterile environment and therefor do not require sterile method treatment. Take the 4x4s out of the wrappers and seal them in a ziplock bag, you can fit about 14 thousand in the same space as 5 in their factory wrappers. Just make sure the wound is relatively clean, risk of infection is very minimal in the time and theater most of us are working in.

    If you want to get fancy carry betadine pads, drop a few in a water bottle, shake, poke a hole in the cap and use it to irrigate the wound. Tincture of benzoin is a godsend when things dont stick to skin. They come in tiny little crush vials, put a few in the space of the 2" tape to keep them from being crushed by accident, if you want to use steri-strips, you will need benzoin.

    Thats all I have for now, this was really just a time filler for me while sitting at my desk staring at the wall. Questions, comments and concerns welcome.

    I know there are a lot of other medical dudes on here, CONSTRUCTIVE criticism is always welcome, just remember there is more than 1 way to suture a wound.
     
    noDave, YoungBuddah, jryan06 and 10 others like this.
  2. Stryker

    Stryker Loaded Pockets

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    Great post! Two other comments:

    (1) Standardize ALL your blow-out kits so you know where things are in a crises.

    (2) Train on the use of the equipment before you are unexpectedly required to use it in a life threatening situation. A Video is NOT ENOUGH. Do enough hands-on training so you can save a life during hours of darkness and in bad weather with slippery hands. Keep that proficiency current by periodic refresher training.

    Stay Prepared and Vigilant
     
  3. CBRNE

    CBRNE Loaded Pockets

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    Good points. Standardizing kits is a big plus, although sometimes it is tough depending on your parameters. The kit on my plate carrier is much more robust than the ankle kit I have. Same capabilities, more-or-less, but much different execution.
     
  4. Krby0

    Krby0 Loaded Pockets

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    Now I'm curious, what sort of class or training should one take in order to know how and properly use a blowout kit? Does EMT-B teach that?

    Sent from my HTC One_M8 using Tapatalk
     
  5. HardToHandle

    HardToHandle Loaded Pockets

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    I took the EMT basic a decade ago and it is a good start. The National Registry course has trauma along with many other prehospital medical elements. EMT B covers a lot areas not associated with blow out kits.

    I recently took a tactically focused refresher from a local Paramedic Instructor, focusing on TQs. I took it with some firefighters, cops and a recent military tactical combat casualty course attendee. Good base instruction and better discussion from the real life perspective.

    There are a lot of reportedly solid medical courses from shooting/tactical training providers. I do not have enough experience to recommend anyone specific.
     
  6. CBRNE

    CBRNE Loaded Pockets

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    EMT-B Will cover much, much more than the contents of this post. It depends on how much time (money) you want to dedicate to it. If you are just taking it for basic knowledge and do not plan on actively using the knowledge, skills and abilities (KSAs) on a regular basis, I would say it is not really worth it. Take a look at The National Association of EMTs (Naemt) website, they have a course called B-CON (Bleeding control) designed for non-medical responders. I honestly do not have a good grasp on the civilian training market right now.
     
  7. BklynBoy

    BklynBoy Loaded Pockets

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    Thanks for the tip about the B-Con course. I just read the materials and they succinctly taught the use of the most common materials carried in a blowout kit. As to the OP. I have boo boo kits in my briefcase and in my car as well as a large, sealed plastic bin of all sorts of first aid gear in my house. I have blow out kits in the house, the car and one for my range bag (or to carry when hunting). I am not in combat, so I do not carry it on my person every day (even when CCing).

    My car first aid kits consist of augmented boo boo kits from Adventure Medical plus my blowout kit in a separate Loksac stored at the top of the medical bag. I just got a new, second car, so I just ordered a new medical kit from Rescue Essentials this time and the additional things I needed for the new blow-out kit. Apart from the boo boo and GSW kits in the car, the other things I always have in the car are designed to treat people in the 15 or so minutes I would expect to need to wait until the EMTs arrive. Out and about on the road, I assume the most likely things I would run across are auto accidents (for which the GSW kit is appropriate for severe bleeding), shock, hypothermia and dehydration/sun stroke. My cars are always stocked with fire extinguishers, blankets, water and electrolytes, instant Ice/heat and a poncho or tarp.
     
    Last edited by BklynBoy, Jul 8, 2016
  8. Fire Fighter

    Fire Fighter Loaded Pockets

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    Thanks for the info especially on the RATS. As a fire fighter the one injury we rarely sustain is a burn injury as you are fully protected. If you are burned then your gear has failed. If your gear has failed then the fire was greater than you could have planned for. Simply put you are now in a bad way. Our biggest threat is heat exhaustion so we carry plenty of fluids in all our pockets.

    Thanks for the little things.
     
  9. JIM

    JIM Loaded Pockets

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    You talk total nonsence: performing first aid is impossible without a rubber chicken..
     
  10. CBRNE

    CBRNE Loaded Pockets

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    I had to carry one in my pocket for a while.
     
    Hjort likes this.
  11. nitevision

    nitevision Loaded Pockets

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    Am I glad to have you here! Am looking at building a blowout kit for myself in light of recent events.

    Here is my current list:
    Tourniquets
    Israeli bandages
    Gauze
    Tape
    Gloves
    Glow sticks
    Shears (Benchmade 5 hook recommended on these forums as well)
    Sharpie

    I was looking at something like this to form the core of the kit, but it contains OLAES instead of Israeli bandages.

    Then there is also this set that looks a little more complete.

    The first one also includes instructions on how to use it (no substitute for training, but I think it is good to have just in case). There is also the fact that one of the kits gives me SOFT while the other gives me CAT.

    I guess zipper pouches are out then? What should I look for in a med pouch to ensure I can access my gear?
     
    Last edited by nitevision, Jul 23, 2016
  12. CBRNE

    CBRNE Loaded Pockets

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    I would suggest keeping everything together, IE not having part of your kit vacuum-sealed and other parts separate, harder to see what you have. Honestly the OLAES is a better bandage overall than the Israeli, so no issue there. SOF-T vs. CAT is a pretty worthless argument, they both perform more-or-less the same, data shows minimal differences overall. As far as pouches go, if you need to manipulate a tiny zipper pull to open the kit, I would say dont get it. Look for pouches that have large pulls or velcro so you can just grab it and tear it open. You will notice the ITS/ZULU pouches DO have zippers, but they are connected via a large piece of webbing so I can just pull it open in one gross motion.

    Take a look at my other post on my 1st/2nd line gear
     
  13. chaosmagnet
    • GITD Manix 2XL Owner
    • In Omnia Paratus

    chaosmagnet Loaded Pockets

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    For buddy aid, this is true. The SOFTT and particularly the SOFTT-W are excellent and two of my instructors (both are active-duty paramedics and previous-service Army Medics) say that they often work better than the CAT in real-world applications. However, the CAT is much easier to use for self aid. We've baked this off a bunch of times and the CAT, particularly the Gen7, is much faster to apply for self-aid.

    I've never applied a tourniquet outside of training. I have no connection with any products mentioned here and I am not a medical professional.
     
    CBRNE likes this.
  14. bmstrong

    bmstrong Loaded Pockets

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    Interesting thread.
     
  15. CBRNE

    CBRNE Loaded Pockets

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    Cool, havent heard or seen that but sounds legit
     
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  16. maillet282

    maillet282 Loaded Pockets

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    Having used both the CAT and the SOF-T during my deployments. I agree with saying that they are pretty much equals. I only had 2 SOF-T but ha around 8 or 9 CATS in my led bag. I kept the SOF-T for the guys that had thighs the size of my head or bigger besides. That there wasn't much difference that I have seen between the 2

    If you find a pouch that you really like but it has small (Ish) zippers you can always add a zipper pull tab to it. I have made some that are made of hub line ( the thin red rope used to shoot between ships during replenishment at sea ) super strong stuff let me see if I can find a pic of some of the zipper tabs that I am talking about
     
  17. maillet282

    maillet282 Loaded Pockets

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    [​IMG]

    These can be easily made to any length or with to suit your personal needs and preferences
     
  18. CBRNE

    CBRNE Loaded Pockets

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    That is always a possibility. If you look at the ZULU Nylon pouches I like, they kind of "filet" open when you pull the nylon handle, which in turn opens the zippers. I have also tried tying the zipper pulls together with dummy cord (really thin nylon cordage) so you can pull that as well, it works, but I dont bother with the zulu pouches.
     
  19. maillet282

    maillet282 Loaded Pockets

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    I've only seen pictures of the Zulu Pouches when I was looking for a sun visor Molle panel a few months ago. Never really had heard of the company or seen any of their products
     
  20. CBRNE

    CBRNE Loaded Pockets

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    Zulu is a solid company, american stuff. The med pouches were designed in conjunction with ITS Tactical.