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Small All Around First Aid Kit

Discussion in 'First Aid Station' started by adnj, Aug 11, 2010.

  1. Flight-ER-Doc

    Flight-ER-Doc Loaded Pockets

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    If people are going to read medical journal reports, they should first read a book that explains what testing is about like this one: http://www.amazon.com/Studying-Study-Testing-Test-Pediatrics/dp/0781745764/ref=sr_1_1?s=books&ie=UTF8&qid=1282488575&sr=1-1 and also this one http://www.amazon.com/s/ref=nb_sb_ss_i_0_20?url=search-alias%3Dstripbooks&field-keywords=the+trouble+with+medical+journals&sprefix=the+trouble+with+med&ih=14_4_1_1_0_0_0_0_0_1.2_174&fsc=19 written by the former chief editor of the BMJ, who explains just how shoddy the science is in even the most prestigous medical journals (like the BMJ, Lancet, NEJM, JAMA to name four).

    What the quoted study says is half the time the systolic is there at all three sites, with a bp of more than 76? OK, so? What about the other half of the time? An indicator that is only as good as flipping a coin isn't worth jack, and worrying about it just wastes time: If you base medical judgment on that sort of criteria save time and flip a quarter.

    The lower BP ranges? Worse than flipping a coin.

    And what about the outliers in society? People who are in very good health who's resting BP is naturally low? patients who are hypothermic? patients that are hyperthermic? What do you do then, even with a BP cuff? What about people who are having confounding issues - a vasovagal episode along with a bleed? Their BP will be OK for awhile, and then will crash faster than windows-95.

    Finally, BP's are kind of useless taken alone. If they show a trend (decreasing) thats bad. But it has to be a trend, you can't extrapolate a trend from one (or two, or three) markers. Whats important prehospital is "is the patient stable?" If they are mentating (responding appropriately to questions, or responding appropriately to noxious stimulus) that tells you about all you need to know, but even that is subject to errors, what if the patients baseline status is flaky, and never responds appropriately to questions? What if they're on drugs, or have been exposed to some sort of toxin?
     
  2. Flight-ER-Doc

    Flight-ER-Doc Loaded Pockets

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    I keep full masks handy in the cars, and in my kits but not on my keychain. We have them at work, and if I'm not at work the odds are good I'll have a car or kit handy.
     
  3. cap6888
    • In Omnia Paratus

    cap6888 Loaded Pockets

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    I have a little keychain mask in my kits. It is better than nothing. Frankly, I would be more worried about someone aspirating in my mouth than the actual mouth to mouth contact. And these pocket masks serve this purpose very well.
     
  4. cap6888
    • In Omnia Paratus

    cap6888 Loaded Pockets

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    @ Doc and Ralphrepo

    To prevent further hijacking of this thread, I think Ralph hit it on the head.....treat the patient. It's like having patient who is in Afib, but is completely asymptomatic, if it ain't broke don't fix it. I know it is standard practice in my department that if a patient is being transported by an ALS provider, an IV gets started with a saline lock. We don't push any fluids unless the symptoms warrant it. Doc mentioned another good point, some people will just normally have a low BP (smaller statures, athletes, etc). It goes back to the first sentence.

    Sorry to the OP for derailing this post.
     
  5. StealthChaser13

    StealthChaser13 Loaded Pockets

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    I carry a keychain breathing barrier on my keys, and I carry one in the FAK in my truck.
     
  6. Mitchell

    Mitchell Loaded Pockets

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    Thanks, that's pretty much what I was thinking about as well.

    And, to be clear, I have full masks in the car and at home. I'm thinking about the small kit I carry in my regular EDC bag.
     
  7. rckshrk

    rckshrk Loaded Pockets

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    Full size mask at home and in cars, key chain mask everywhere else with the addition of a Pediatric mask kept with the FAK in my little ones diaper bag since I'm likely to be around other kids when I'm with him.
     
  8. kirbysdl
    • In Omnia Paratus

    kirbysdl Loaded Pockets

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    Since the OP mentioned jellyfish, perhaps taking a bottle of vinegar would be a good idea when heading to water where jellyfish are known to hang out. Some say that vinegar is a good way to neutralize the stinging cells of jellyfish. Can i get any confirmation of that?
     
  9. comando293

    comando293 Loaded Pockets

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    In reply to above, yes, vinegar will help reduce pain. Other first aid for jellyfish includes rubbing with sand, and cooling with seawater. Freshwater, among other things, is very bad. Don't touch an affected area without gloves, or you risk getting your hands stung. Bear in mind, when I have used it before, it took quite a bit, like 8-16 oz. to be effective. Don't waste your time with a small bottle. If you're gunna bring it, bring it like you mean it.

    I really hate jellyfish.
     
  10. scríbhneoir
    • Administrator

    scríbhneoir Uber Prepared
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    Another option for jelly fish stings is unflavored meat tenderizer. The papain does the trick, though you don't want to leave it on for more than 15 minutes. It was recommended on the Texas Gulf Coast where those darn Portuguese Men of War would bob in by the bunches. I've read where vinegar should be left on for 30 minutes. We put a shaker of meat tenderizer in the beach bag just in case.
     
  11. widgetdr

    widgetdr Loaded Pockets

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    I am not a medic by any stretch but have fished for years on the gulf coast from TX to FL and can attest that the meat tenderizer works.
     
  12. RogerStenning

    RogerStenning EDC Junkie

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    My FAK, that I carry pretty much everywhere, is based on the contents of the "Lifesystems Pocket First Aid Kit".
    The kit is listed as follows on their website:

    I've modified it as follows:

    I added a few more brand-name self-adhesive plasters of various sizes and materials to the pack, (it's amazing how a fabric plaster will be better for one reason or another, than a "washable" nylon one, and vice-verse!)

    I also dumped the "Small crepe bandage" and replaced is with a CPR mask (that's a no-brainer, folks) and a US Army-issue FFD (First Field Dressing), as they're by far one of the best large wound dressings I know of. I'd've used a British Issue one, but they're MASSIVE (twice the packed size of the American one).

    The "Antiseptic cream" was dumped as a London Ambulance Paramedic I met a while back told me in no uncertain terms that it was "about as useful as a Chocolate Tea Pot": The antiseptic wipes would be just as effective, and "wouldn't gum up the works later on if things got worse".

    Here's a photo of the pack and contents.

    [​IMG]

    It fits right into the side pocket of a MaxPed Jumbo or clone (I've got a UTG clone).

    I generally carry a few more bits and bobs as well, which while not fitting in the FAK pack, do travel with it, as follows:

    • Small FAK (in red pack)
    • 48 x hours worth Personal Medicines, (14 pills in all in 12-hour sectioned HiViz container)
      (NOTE: Prescription Drugs),
    • GTN spray (GlycerylTriNitrate, a heart/angina medicine)
      (NOTE: Prescription Drug),
    • Tube of Tyrozets (over-the-counter pharmacy-only mild antibiotic and throat painkiller),
    • 6 x foil-wrapped Rennie dual-action tablets (Antacid),
    • Medicine bottle of decanted "Neurofen Meltlets" (fast-acting over-the-counter pain killers that you can take without water),
    • a small bottle of Optrex Actimist (eye refresher),
    • pair of non-latex gloves,
    • pump-bottle of anti-bac gel hand cleanser

    It all fits right on in that side pocket too :)

    Another red note...

    UK rules prohibit the deployment of any drug by one person to another, unless the issuer is properly licenced by the appropriate authorities. This means, in effect, that you can't even give someone as much as an aspirin, let alone a cold cure remedy, without a licence of some form.

    It's for THAT reason that the FAK is separate in packing from the personal meds - I hope that's reasonably clear :)


    hope the above helps :)
     
  13. KMAC179

    KMAC179 Loaded Pockets

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    I am sure you mean nurses and medics that happen to be poorly trained, not that medics and nurses are poorly trained in general, correct?

    We (medics) start them on *everyone* that meets the criteria for one because that is what our standing orders dictate. Failure to do so will result in a "QA" flag in our chart as to why we did not start one. ALS ambulances bring the first 15-30 min. of the ER to the pt (but I am sure you already know that, Dr.) we get the basic stuff out of the way to expedite pt. care in the ER (IV access, labs, ECG, ect). At least that is the case in all 7 EMS sytems I have worked in, in all 3 States I have worked in.

    I am just putting this out there, your wording and tone did not sit well with me, if you were not intending for that tone, then disregard.
     
  14. cap6888
    • In Omnia Paratus

    cap6888 Loaded Pockets

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    I took a little offense to his wording also, but that is the problem with forums, you can't tell what "tone" people are trying to put across. Where I work, we use a tiered system which has BLS units (EMTs) and ALS units (Paramedics). If I am transporting a patient to the hospital as a medic, there is an index of suspicion that they are having a medical emergency or traumatic injury that requires ALS intervention. If I were to show up without an IV established I would get all sorts of grief from the ER staff.
     
  15. KMAC179

    KMAC179 Loaded Pockets

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    In my system, we also have an ALS/BLS tiered system. There are both "B" and "P" ambualnces in the City. If there is a pt. in a "P" ambulance and is and if the pt. fits "ALS criteria" our standing orders are to establish IV access and draw a basic lab panel. Failure to do so without proper documentation would result in a QA flag, flak from the ER, and a write up from clinical.
     
  16. aussieknifeguy

    aussieknifeguy Empty Pockets

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    i recommend a styptic pencil it stops small cuts bleeding
     
  17. Flight-ER-Doc

    Flight-ER-Doc Loaded Pockets

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    OK, the protocols are poorly written then.

    I'm the EMS director for a fire department, the EMS director for a different multi-county EMS agency with ALS/BLS providers, mostly volunteers (very rural).

    We have protocols, but I also try and teach the reason for the protocol, and that if anyone has any question about following it to call base.

    Examples are starting an IV on a person with audibly wet (without using a stethoscope) lung sounds.....not a good idea, the excuse was the 'protocol' said start one in case drugs were needed (the protocol actually says establish IV access....they carry saline locks....).

    I too had to deal with brain-dead protocols when I was a medic (in the dawn of time). At least I had higher-ups that listened and educated, instead of dictated. Thats how I try and operate.

    Likewise, in a trauma in the ED, there is usually some nurse that will swoop in and start an IV. OK, why? "Because" is not an acceptable answer, neither is "we always do that". Second on the list is the "Foley of life", like a foley will make a bit of difference in someone surviving a trauma or not in the first ten minutes...

    There are good reasons to do all interventions - sometimes. There is no good reason to perform an intervention, all the time.
     
  18. VinnyP
    • In Omnia Paratus

    VinnyP Loaded Pockets

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    News to me, do you have a source? I carry and would offer drugs with a recommendation that they take in the right circumstances. I can use medical gases if appropriate I have no licence but it falls within my training; whilst this is part of my job the course is delivered by commercial companies that deliver to the private sector. Are you telling me you can't treat a wound with antiseptic? In the UK I can't supply controlled prescription or pharmacy meds to anyone but the script holder except in certain tight circumstances, but had no idea there were any restrictions on anything else.
     
  19. KMAC179

    KMAC179 Loaded Pockets

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    Fair enough. It can be argued back and fourth for years. Does every single patient need iv access? No. However, if you look at the bulk of what we treat as ALS in the City, you have asthmatics, CHF, CP, AMS, Status EP, diabetics and trauma. Now why would there be a need for VA in these pt's? Asthmatics get mag sulfate along with albuterol, breathine and solumedrol for severe cases, also we can RSI if needed. CHF will get nitrates and CPAP, again RSI as needed. In those cases IV access is needed, better to start the line in case it's needed rather than waiting until it's needed. AMS is too broad of a field to get into. CP, well, ACLS algorithms take care of that. Status EP, paralytics and again, RSI. Diabetics is another obvious one. What we have left is trauma, and we both know where that argument leads. We treat very agressive in the field here and it is quite common for asthmatics to wait untill they need to be tubed to call 911. There is always going to be difference in opinion and treatment modality system-to-system. Honestly the part about establishing access was second to the "poorly trained" comment, that is what caught my attention. I appreciate your view but one protocol philosophy will never fit every EMS system, there are too many factors.
     
  20. Mitchell

    Mitchell Loaded Pockets

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    As a diabetic, I'm curious. What do you plan to give me that would automatically buy me an IV?