What is in your medical/first aid kit, show and tell

Graveworm

Life Member
Sep 2, 2011
366
0
London UK
In civilian life these procedures don't translate well and by using them you will be doing more harm than good.

The other thing is that armed forces doctors and medics know how to deal with products like celox, they have been trained and taught how to clean the wound, what chemicals to use, so understand the product, that's very very unlikely to be the case in civilian life.

Again pressure and elevation weight absolutely nothing, take no space and ave a track record of working in real life.
Leave celox and tampons for combat medics and play acting soldiers.

I tend to stay out of these recently as, in my opinion, the best advice usually come early and it's always along the lines of: Get trained, stay trained, do what you have been trained to do, and carry as much as you are comfortable carrying for that, in your fak. I have considered posting what is in my kits for curiosity but the rule above means that that it's only relevant for me (Except the kits I get issued I guess)

However
There are a couple of things here that are factually incorrect. Law enforcement Medics and Ambulance HART teams carry Hemostatic dressings, like Celox and Quikclot, in the civilian world; so I am pretty sure that A&E staff know what to do with them. No chemicals just debriding with water which will happen anyway. Also PHTLS currently teaches that, as it happens, elevation doesn't have a track record for dealing with a catastrophic arterial bleed. " These interventions can no longer be recommended for situations in which direct pressure or a pressure dressing have failed to control a haemorrhage ". http://books.google.co.uk/books?id=...a=X&ei=UbRWU_jdGa-u7Aa2qIDoDw&ved=0CDkQ6AEwAQ
Direct pressure is definitely a big thumbs up or occasionally thumbs in.
 
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TarHeelBrit

Full Member
Mar 13, 2014
687
3
62
Alone now.
As my wife is a retired EMT she likes to keep her skills up and have a nicely equipped bag.













It's a bit big to keep in the car so we have a smaller version in a Condor rip-away EMT pouch.
 

GGTBod

Bushcrafter (boy, I've got a lot to say!)
Mar 28, 2014
3,209
26
1
You could fill my berghaus crusader bergen with that kit, side pouches the lot, by comparison my kit would fit in one of those smaller compartments inside your bag, seems in many cases the size of the kit matches the amount of experience/training of the owner, glad to say my kit speaks for me through and through as i can definitely put on a cracking self adhesive plaster and use an antiseptic wipe to it's full potential
 

TarHeelBrit

Full Member
Mar 13, 2014
687
3
62
Alone now.
We had that kit in the car for the journey from Anchorage AK to Raleigh NC and only broke it out once. We were at a rest area and we noticed a man checking out all the vending machines. I jokingly said don't they have your favourite candy? he said he was looking for some pain killers as his wife had a pounding headache and hundreds of miles to get home. My wife said I think we can help so while she checks out the woman I broke out and instant ice pack once she was satisfied it was nothing that required a full blown ambulance she asked if the woman could tolerate Ibuprofen. Her husband said it was okay so she got some and a few more for the trip home just in case she needed them.

The reaction from this man was like my wife had just saved his wifes life he was so grateful it was almost embarrassing we had a small crowd around us by the time he had finished. After a short while she felt better with an ice pack on the back of her neck and Ibuprofen working we parted company.
 

GGTBod

Bushcrafter (boy, I've got a lot to say!)
Mar 28, 2014
3,209
26
1
Maybe never saved his wife's life in a literal sense but you definitely saved him from the grief he must have been getting for him to be desperately searching a vending machine for pain relief and the one he would have continued to get until he got said pain relief.

One day i will gallantly come to the rescue with my antiseptic cream and a sticky plaster
 

cbr6fs

Native
Mar 30, 2011
1,620
0
Athens, Greece
I tend to stay out of these recently as, in my opinion, the best advice usually come early and it's always along the lines of: Get trained, stay trained, do what you have been trained to do, and carry as much as you are comfortable carrying for that, in your fak. I have considered posting what is in my kits for curiosity but the rule above means that that it's only relevant for me (Except the kits I get issued I guess)

However
There are a couple of things here that are factually incorrect. Law enforcement Medics and Ambulance HART teams carry Hemostatic dressings, like Celox and Quikclot, in the civilian world; so I am pretty sure that A&E staff know what to do with them. No chemicals just debriding with water which will happen anyway. Also PHTLS currently teaches that, as it happens, elevation doesn't have a track record for dealing with a catastrophic arterial bleed. " These interventions can no longer be recommended for situations in which direct pressure or a pressure dressing have failed to control a haemorrhage ". http://books.google.co.uk/books?id=...a=X&ei=UbRWU_jdGa-u7Aa2qIDoDw&ved=0CDkQ6AEwAQ
Direct pressure is definitely a big thumbs up or occasionally thumbs in.

Fair enough.

One thing i will say is that Law enforcement medics and ambulance HART teams in the states are not the norm in the UK.

We are talking about a hiking/camping trip FAK, the type of incidents the LE medics and HART teams treat is NOT going to be the type of injury found while camping or hiking.

The article you linked to was under a section specifically talking about tourniquet, if you read the paragraph above it states.
It would be a serious error to deliver a well-packaged trauma victim to the receiving facility with two IV lines inserted and neatly taped in place, but who is dying from a haemorrhage of a wound that has only trauma dressings taped in place and no direct pressure applied
The type of clotting bandages we are talking about comes in that same category.

You are also talking about trained, experienced, professional paramedics who deal with severe injuries literally on a daily basis, they have the skill and experience to analyse a trauma and treat it accordingly.

These clotting type products have been on the market for years now, any NHS hospital can buy them, any paramedic or ambulance station can stock them.
The fact is though that hardly any do (in my experience and i have asked).

Is any civilian organisation like the NHS or St Johns training it's staff and trainees in the use of these types of dressings?
I can't honestly say as i have my ear to the ground, but in the year or so since i lasted looked into it there was not one civilian organisation training or recommending it's use.


To clarify i'm not saying it's useless in all situations.
Obviously in war zones, police shoot outs and big open wounds like chainsaw injuries they have a place, my point is that i don't see a realistic scenario for a camper/bushcrafter/hiker where it would be as good as pressure and elevation.
I do see a scenario where premature clotting could cause problems on a injury, i also see problems where a amateur not trained in the use of clotting products will not clean a wound enough (easy to do with a screaming casualty up a mountain with very little clean water) and that be prematurely clotting the wound it will complicate further treatment needing painful opening up on the wound.

As i've said though, please don't take my word for it.
Speak with a emergency nurse, doctor or paramedic and get their view on it, it is important to let them know you are talking specifically about a outdoors, hiking, camping, bushcraft type injury.
 

Graveworm

Life Member
Sep 2, 2011
366
0
London UK
These are UK medics and HART teams. Not the norm, but not rare. My point was that A&E can deal with combat gauze and haemostatics. Sorry if I was not clear if you don't know how to use them then you won't carry them and I am not advocating otherwise. I am also saying they have a limited use and skill and other kit is a priority. What is on an ambulance is actually less of any issue because their time at to A and E. is not that long. The highest percentage of survivable fatal injuries in the UK are extremity bleeds. Not war zones or shoot outs just overall. In a remote Bushcraft setting that's worse. If you, or someone with you, doesn't stop the bleeding then by the time an ambulance gets there it's too late.
Your description of clotting products is not one I recognise. You don't clean before you use them, you don't use them where pressure works and elevation is not the right thing to do for a catastrophic bleed.
 

sausage100uk

Settler
May 4, 2013
538
0
United Kingdom
Ok, heres my 2p. In 10yrs prehospital medicine i have never been to a bleed that wasnt controled by primary means (pressure and elevation), this has included open long bone fractures, truamatic amputations,direct artery dissecting wounds and dialysis patients whos av shunts have haemmorhaged. The last time i saw a tourniquet used was to shut down a patients arms as the hems dr wanted her core isolated. However, i carry a scope and forceps as thats one bit of kit that could get someone out of the **** if they choke on their sausage butty and the normal 1st aid doesnt cut it. I also carry a large bore cannula as ive seen how quickly someone can tension from a supposedly minor chest injury. Tampons, celox and other gucci kit are personal preference but i dont carty them as i dont think theyre needed.

:D
 
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Bluffer

Nomad
Apr 12, 2013
464
1
North Yorkshire
Ok, heres my 2p. In 10yrs prehospital medicine i have never been to a bleed that wasnt controled by primary means (pressure and elevation), this has included open long bone fractures, truamatic amputations,direct artery dissecting wounds and dialysis patients whos av shunts have haemmorhaged. The last time i saw a tourniquet used was to shut down a patients arms as the hems dr wanted her core isolated. However, i carry a scope and forceps as thats one bit of kit that could get someone out of the **** if they choke on their sausage butty and the normal 1st aid doesnt cut it. I also carry a large bore cannula as ive seen how quickly someone can tension from a supposedly minor chest injury. Tampons, celox and other gucci kit are personal preference but i dont carty them as i dont think theyre needed.

:D

Are you a HCPC registered Paramedic?
 

Gimli

Member
Jun 2, 2014
29
3
United Kingdom
Ok, heres my 2p. In 10yrs prehospital medicine i have never been to a bleed that wasnt controled by primary means (pressure and elevation), this has included open long bone fractures, truamatic amputations,direct artery dissecting wounds and dialysis patients whos av shunts have haemmorhaged. The last time i saw a tourniquet used was to shut down a patients arms as the hems dr wanted her core isolated. However, i carry a scope and forceps as thats one bit of kit that could get someone out of the **** if they choke on their sausage butty and the normal 1st aid doesnt cut it. I also carry a large bore cannula as ive seen how quickly someone can tension from a supposedly minor chest injury. Tampons, celox and other gucci kit are personal preference but i dont carty them as i dont think theyre needed.

:D

How are you diagnosing a tension without and diagnostic kit? Not even a stethoscope! How many large bore cannula do you carry? A HEMS Doc using tourniquet to isolate a core?? Can you explain that one to me please? In 16 years of pre-hospital care I've known a tourniquet to be used a good few times, infact I've known them to be used more often than the old laryngoscope and forceps on a choking pt.
 

cbr6fs

Native
Mar 30, 2011
1,620
0
Athens, Greece
These are UK medics and HART teams. Not the norm, but not rare. My point was that A&E can deal with combat gauze and haemostatics. Sorry if I was not clear if you don't know how to use them then you won't carry them and I am not advocating otherwise. I am also saying they have a limited use and skill and other kit is a priority. What is on an ambulance is actually less of any issue because their time at to A and E. is not that long.

My objection to using clotting bandages was/is:
The professionals who you hand the casualty off to do NOT want you to use these sort of products, at least the ones i've spoken to in the UK and Europe.
It makes the wound messy, when it does clot that clot is then removed with the bandage (which the nurse/medic HAS to do) it's also a nightmare to clean the wound as not only has the clotting agent got into and around the wound.
If clotting has occurred and the wound wasn't cleaned beforehand your just trapping in dirt and are ripe for a infection.

The highest percentage of survivable fatal injuries in the UK are extremity bleeds. Not war zones or shoot outs just overall.

Not to sure where you are getting your information from, but according to the HSE an organisation specifically setup to log incidents like this, their take is and i quote:

Over half the fatal injuries to workers were of three kinds: falls from height; contact with moving machinery; and being struck by a vehicle
Full report here:
http://www.hse.gov.uk/statistics/causinj/kinds-of-accident.pdf

you don't use them where pressure works and elevation is not the right thing to do for a catastrophic bleed.

To quote a professional
Ok, heres my 2p. In 10yrs prehospital medicine i have never been to a bleed that wasnt controled by primary means (pressure and elevation), this has included open long bone fractures, truamatic amputations,direct artery dissecting wounds and dialysis patients whos av shunts have haemmorhaged.

If you only use them where pressure and elevation doesn't work then according to at least 1 professional you will never use them.

As i say i haven't just woken up one morning and decided to argue about this, safety for my loved ones when out hiking is something i take extremely seriously.
As a result i have spoken with many civilian health professionals and not a single one recommended clotting power or clotting type bandages, again not 1 single health care professional, the people that deal with the casualty once you've handed him/her over.

Like anything in life these products have their advantages and disadvantages, if treating a trauma under fire the disadvantages are rendered mute.
In the civilian world the disadvantages are real, it's not like pressure and elevation isn't working.

Again though please do not take my word for it, i'm not saying you or the others that carry these products are wrong.
I'm simply saying it is well worth speaking with several AE nurses, doctors or paramedics to get their opinion, as i say these are the people that will have to work around or correct any treatment mistakes we have made.

*Sausage, sorry for putting you on the spot, but i felt that a direct quote would put the point across better, if you have any objection please let me know and i will remove your quote staight away.

Cheers
Mark
 

cbr6fs

Native
Mar 30, 2011
1,620
0
Athens, Greece
Ok thats fine. Im not going to explain. This seems to be turning into a bit of a pissing contest.

It does get frustrating.

I honestly believe that some folks chose kit then just create fantasies to justify their choices.

Sad thing is that if they want to carry something is their choice all the have to say is i carry it because i want to, instead silly scenarios from completely different activities are used, once they are called out on this the goal posts move.

What gets me is i'm not saying any ones kit choices are wrong.
I'm reporting back my experiences based upon the professionals i have spoken to and requesting that they too speak to the pro's before treating some poor bugger with inappropriate treatment.

How can anyone consider that not a good thing?
Folks carry these kits in the hope they are never used, but we carry them anyways because if we ever come across someone that does need help and we are unable to help because of lack of knowledge and bandage we know that would be a life changing pressure to have around your neck.
So speaking to professionals that deal with most the injuries we are likely to see on a daily basis is surely a win win?

If the local AE department says that clotting type bandages are fantastic then i'll happily re-evaluate my opinion.
Good honest advice, from experienced professionals, quicker easier to use treatment = win, win

If on t'other have they say it makes the wound messy, difficult and painful to clean, doesn't do anything pressure and elevation doesn't do, then is it not better to heed their advice and use alternative methods?
Again surly that's a win, win again


Either way any casualties that we treat will be getting better treatment, so who cares about right or wrong point scoring on a forum in comparison.
 
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John Fenna

Lifetime Member & Maker
Oct 7, 2006
23,304
3,088
67
Pembrokeshire
The recipe is simple - Get trained, keep up the training, carry what you are trained to use and is appropriate to the risks of the trip you are undertaking.

There is no point in carrying stuff that you do not have the training to use.
There is no point in carrying stuff that is very unlikely to be needed.
There is no excuse for not getting at least a basic level of training.

In all my years of "adventuring", expedition leading, outdoor skills instruction, driving on overcrowded roads etc the most used bit of kit in my pack has been a compression bandage and some sticking plasters!
I try and have an update on my training every year (sometimes work pays for it :) ) and I check my FAKs every year.
As with most of the Bushcraft skills set - it is not kit but knowledge that proves most useful in most situations!

With minimal kit - well none actually - I have brought the dead back to life - from flat line to spontaneous output .. unfortunately a week later the subject died (permanently) in hospital without having regained consciousness - despite having all the resources of a hospital to hand....
 

Graveworm

Life Member
Sep 2, 2011
366
0
London UK
My objection to using clotting bandages was/is:
The professionals who you hand the casualty off to do NOT want you to use these sort of products, at least the ones i've spoken to in the UK and Europe.
It's possible you have spoken to more than me but it may be you need to speak to more, or more regularly, they know that when they are used appropriately they are the difference between getting to A&E or the morgue. They are being taught for use by a lot of professionals these days in the UK and Europe. I am trained in their use and train others in their use (If a mod wants to PM me I will happily send an e-mail from my government work address to verify who I am and my qualifications, since that seems to be an issue for some), some of that training is working in casualty and on ambulances in the UK. if I didn't use them when they were appropriate then I would be criticised and would almost certainly find myself in court.
It makes the wound messy, when it does clot that clot is then removed with the bandage (which the nurse/medic HAS to do) it's also a nightmare to clean the wound as not only has the clotting agent got into and around the wound.
Some of all clots are removed with the dressing hemostatics are no worse in that regard.

If clotting has occurred and the wound wasn't cleaned beforehand your just trapping in dirt and are ripe for a infection.

If you have time to debride and clean a wound then you shouldn't be using hemostatics.

Not to sure where you are getting your information from, but according to the HSE an organisation specifically setup to log incidents like this, their take is and i quote:
Over half the fatal injuries to workers were of three kinds: falls from height; contact with moving machinery; and being struck by a vehicle
They are mechanism of injury, not the injury and I said SURVIVABLE fatal injuries which are the most worrying because those are ones where people died but would have lived if there had been appropriate early intervention (Or First aid as it's often known) It was part of a study carried out reviewing coroners courts a few years back it's quoted in a lot of text books and is known as the "Golden Hours study"

To quote a professional
I am a professional I don't doubt what they said but I have needed and used them and tourniquets. If that professional works on an ambulance then the person has already survived long enough for the ambulance to get there and they are able to get that person to a hospital in minutes whilst being able to keep the pressure on for most of that time. A really good case scenario in a remote rural setting is 30 minutes from injury to ambulance medical professionals arriving and then much longer to hospital. Worse case is days. I can apply a tourniquet to myself, I can maintain pressure long enough for combat gauze to work, I can't put the kind of pressure on my own wound for long enough to have any chance of stemming an exsanguinating wound. Similarly if I have to do that for one casualty then that's all I can do, I can't treat other injuries or other casualties.

Elevation is being phased out; it's out of most curriculums now; we are no longer taught it or teach it for catastrophic injuries because, even if it does work, (And there is no evidence it does) it impairs the ability to apply direct pressure, transport the patient and carry out other procedures. Red cross and St johns are difficult because they need to reprint a lot of text books and retrain a lot of volunteers and trainers so they are glacially slow to change.

As i say i haven't just woken up one morning and decided to argue about this, safety for my loved ones when out hiking is something i take extremely seriously.
As a result i have spoken with many civilian health professionals and not a single one recommended clotting power or clotting type bandages, again not 1 single health care professional, the people that deal with the casualty once you've handed him/her over.

By taking what they say seriously and getting training then you have already done more than the vast majority. I applaud you for that.

No one recommends clotting "Powders" and hasn't for years, they have not been available for years and all have now passed their use by dates. As for recommending clotting "bandages", if it's part of your training and protocols, then when they are indicated you should use them. These are very rare, I don't carry one every day or even every trip but it's not uncommon, I always have one at work. If I or those I treat get handed over to a doctor in circumstances where I have used clotting agents then that's me definitely having a good day. Once again they are for when the alternative is dying not routinely to stop bleeding.

There are OTC clotting sponges which are designed for that (Quikclot sport etc) I got given some to take a look at. Personally I would never have used them and gave them away. I don't think they would do much harm but it is not designed for the same purpose as combat gauze etc.

Again though please do not take my word for it, i'm not saying you or the others that carry these products are wrong. I carry
I'm simply saying it is well worth speaking with several AE nurses, doctors or paramedics to get their opinion, as i say these are the people that will have to work around or correct any treatment mistakes we have made.
I think I have covered this in terms of getting advice, I am mandated to carry them at work (Not just them) and I am encouraged to carry them when not at work.
 

Graveworm

Life Member
Sep 2, 2011
366
0
London UK
I tend to stay out of these recently as, in my opinion, the best advice usually come early and it's always along the lines of: Get trained, stay trained, do what you have been trained to do, and carry as much as you are comfortable carrying for that, in your fak.
He seems like a great bloke, I really wish I had taken his advice :dunno:
 

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