Trauma Kits
Time to check on that bag you hope to never need.
I came across an interesting article this week titled “Advanced Hemostatic Dressings Are Not Superior to Gauze for Care Under Fire Scenarios” :
Like many I have several kits with some very expensive dressings in them which make all sorts of claims. But in recent years in the annual TCCC class I take and the during a 3 day wilderness medical course we did this spring, the consensus has moved away from these dressings. To be clear, no one is saying you can’t use them, but rather that for the money (~$3 as compared to ~$50) spent you are much better off buying plain ol’ gauze and then spending the money you saved on additional supplies (like an extra gen 7 CAT tourniquet!).
For that reason I wanted to go through a very basic kit that most anyone can afford that will satisfy all the elements of MARCH, as well as a way to stay proficient with it in case that day ever comes.
MARCH
M: Massive Hemorrhage: The heart of your kit will always be the gen 7 CAT tourniquet. There are other tourniquets out there, but none offer the success rate of the CAT as well as the ability to put it on yourself. The most common color is black, but an officer responding to a shooting is less likely to sleep well after shooting the guy with an “orange thing” in his hand, so that’s what I choose for most kits. $31.99. DO NOT BUY CHEAP ONES ON AMAZON!
A: Airway: Some carry NPA’s, but buying them is restricted on some sites and having the right size matters. Personally my family trains to use the recovery position for airway on unconscious injured persons.
R: Respiration: The most commonly trained topic here is a penetrating chest wound, and the gold standard for that is the HyFin Vent Chest Seal. At $16.39 for a pair these should be in your kit. You’ll hear a lot about tension pneumothorax, but unless you have the training and license to get the decompression needles this is best left to professionals. One thing you can treat is flail chest, which is when 3 or more ribs are broken in two or more places. This condition can be common in falls and car accidents and can have a mortality rate of up to 40% because the broken ribs move in the opposite direction of the rest of the rib cage during respiration (that’s also how you can diagnose it), and the jagged edges shred precious lung tissue with each breath. The pain this causes can also lead the patient to take short, shallow breaths, leading to oxygen deprivation. As a pre-hospital treatment a couple rolls of kerlix (or other objects like a jacket) can be used apply light pressure to the broken ribs to keep them from moving and held in place with a 6” ace wrap during respiration, preventing further damage to the lung tissue.
C: Circulation: This is where you address any other bleeding that didn’t fall under massive hemorrhage and why the kerlix and ace wrap is such a great multi-purpose pair of items. You can create an effective pressure dressing with just the kerlix if you have to, and the kerlix with ace wrap is extremely effective. Practice, practice, practice!
H: Hypothermia: Don’t let all that work to save a life (or your own) go to waste by allowing them to freeze! And this can happen at surprisingly high temps when the individual has lost a lot of blood. Emergency blankets are cheap, and lightweight. Have them in your kit.
Summing it up
TQ: $31.99
Chest Seals: $16.39
Kerlix for about $5.00
Ace wrap for $3.99
Emergency blanket for about $1 - $3
This will set you back about $60 plus some tax and shipping as applicable. While you might be able to find a “good deal” on something, I caution against buying critical items like the TQ or chest seals from Amazon. Go to NAR and get the real thing.
If you are looking for a small format kit to add to your pack I can’t recommend the M-FAK or OUT-PAK from NAR highly enough. Both will run you about $85.00.
Add-ons
The further away from the main kit it is, the more multi-function it should be. That’s why I carry a triangle bandage (TQ, sling, wound packing) and a SWAT-T (TQ, pressure dressing, wrap) in a cargo pocket. Neither are “ideal” for any job, but are versatile enough to do several things and always better than nothing.
Training
If you are geographically able to take Full Spectrum’s class (linked above) it is hands down the best of it’s kind. If not, find something you can get to at least once a year even if it’s the red cross “Stop the Bleed”.
Then when you get back, consider making a practice kit with some of the materials you carry:
I try to drill family on MARCH and have them use the TQ on themselves and others as well as do pressure dressings once a month. You can do a lot at home by practicing use of the tourniquet, and you can practice packing a wound with just your hand!
Remember, you don’t rise to the occasion so much as fall to the level of your training.