**Read this before anything else in the First Aid section**

[sql_yoda]

People forget that in triage there is an additional catagory in disaster. Expectant, too bad to fix with what is available, or will require more stuff than we can spare with little chance to survive. In most cases of disaster/ end of the world, if they need CPR, they are dead.

I take this advice to heart. Twenty years ago when I had Winter Emergency Care, BLS, ALS, and additional (mostly Red Cross) certs I had all kinds of shit in my FAK, including heavy hare and traction splints that seriously... if you need one today and there is no (even delayed) professional response... you're screwed. Even a compound fracture in the worst situation is going to take more advanced care than the average high school lifeguard can handle. I'm in the process now of culling my bags so that I can actually handle what I think I can handle. Also, now there are some seriously sweet clotting compounds that weren't available back when I thought I was the king shit.

Triage I have been taught... but triage now... It's more likely I'll screw it up than that I would do it right. My FAK needs to be adjusted to handle that likelihood.

[kemper6036]

Saying that no doctor could do your job is just a little ridiculous. There is also absolutely no reason to attack someone just because you think they are infringing on your territory. An MS-III is not some idiot off the street. Maybe his opinion is not completely sound, but there is no reason to just call someone out like that. You learn a lot in med school, and I really don't like hearing how ALL doctors are pretentious.

I didnt say all, I said they were for the most part. Yeah there are probably some kick ass trauma docs that could hang with a street EMT, but I am more than willing to go head to head with any doctor in a field test. Lets do a rapid trauma assessment and medical interventions in a street scenario. I'm no longer an EMT and I am willing to bed I'd still trounce any doctor you put in my path. Street emergency medicine is a completely different animal. As for the 'attack' it wasnt an attack sorry that it came across that way. As for that 'his opinion may not be sound, but there is no reason to call someone out like that" uh, are you serious? If someone's opinion and education are questionable it is totally appropriate to call them out especially if they are despising questionable medical advice. You ever seen a doctor try to stick an IV? I've had to retrain doctors on several occasions in my military career on sticking IVs because it's a skill they never use. I've taken a few doctors out with me in my ambulance so they could see how we lowly EMTs live. For the most part they didnt hang too well. An RN is what? 2 years of school. A paramedic is what? 2 years of school. EMTs are grossly under appreciated in the medical field its terrible. There are some other EMTs on here, such as gana, what would tell you the same thing.

this gave me a good laugh....classic example of professional arrogance

[airballrad]

this gave me a good laugh....classic example of professional arrogance

Is it arrogance if he's right?

[kemper6036]

this gave me a good laugh....classic example of professional arrogance

Is it arrogance if he's right?

i thought the para-god complex was exclusive to actual paramedics. i guess EMTs have their own version now too

[airballrad]

i thought the para-god complex was exclusive to actual paramedics. i guess EMTs have their own version now too

Combat medics are a whole 'nother matter.

[jmstevens2]

Yea, I have seen Doctors/paramedics/EMTs/and Medics that I would want around if I needed help, then again I have seen a lot of each that I would not. In my experience the EMTs seem to think they are "trauma Gods" more often than the other groups.
I figure I can hold my own, I have seen more knowledgeable than I and some that are not as good as I , but I have 30 years as a Paramedic and some as a combat medic to base my opinion on. I am no better than anyone else, I just have seen a bit more than some. I used to keep records for CE reasons, I quit counting at about 17,000 EMS runs. I do know better Paramedics than me too.
Pretty much all Doctors are better than I, some simply have little or no emergency experience, so I have fresher skills than they do in that venue.

[DoctaV]

Here is my two cents on the list of *prefered items* in the Ifac(Individual first aid kit)- experence gained from 5+ years as a recon combat corpsman.

2 Rolls of Kerlix or similar Gauze -must have
2 Ace Wraps - double w/ atleast one of the following sizes, 3" 5" & 6"
1 roll of one inch tape -make that two
1 roll of 3 inch tape/duct tape one of each
Gloves - in a "combat situation" i have never had time to use these.. they honestly took up space in my medbag
bandaids - useless, your not going to be treating boo boo's here, this list is for hard core damage
Kerlix/Gauze at least 4 rolls
Tourinquets - 2
Emergency Trauma Dressing/Izzy or similar pressure dressing-3
Kravats/Triangular bandages - nice to have in the rear but honestly takes up space.. shirts can be used for the same thing and surve a dual purpous
Splinting materials(Sam splints) at least 2, one short ( for arms) one long( legs)
Asherman Chest Seals - DONT WORK WORTH A DAMN!! if you ever get the chance to read the directions on the package it states that it must be placed on a clean dry surface for it to stick. i have never known any penitrating chest wound to be either clean or dry.. i substute a 6x6 patrolioum gauze for this, as patrolioum jelly gauze stick to everything
Quickclot - cant carry enough of it
Hemcon Bandages. can carry enough of it either
EMT-sheers dead usefull
Forceps - nice if you would only need one pair. go to cheeperthandirt.com and get their "minor surgery kit" it has just about every instrument you would ever need
CPR-mask - useless
Burn-dressing / burn-jel dead useful
5 Decades worth of any perscription meds you need to survive - better hope to run across a pharmicy that is empty
Soap - no use for it in the feild.. the feild is dirty and by nature of the fact you will always be too
Hand Sanatizer good to have
Tylenol - nice to have but not recomended..
Asprin - think twice.. may prevent a heart attack but also thins the blood
Motrin - mmm.. good ol' vitiman M. drop it not needed
Immodium - most miss used otc on the market.. plus its really touchy.. take it when you dont really need it and you could become so backed up that you need surgery to correct it.. take too little and all your doing is waisting meds.. wouldnt advise this one
Benadryl - if your packing an epi-pen or a twinject this is not needed
Bacitracin bring it and a fair amount
Hydrocortisone nice but not neccassary
Alcohol (bottle or pads) take pads about a box of em..
Chapstick leave this at home.. has no place in a med bag
Sunscreen pack it just dont go crazy w/ it
hydration salts - take it
Bug Spray another thing that is nice to have.. suggusted to look into military grade DEET
Mole Skin nice to have if your boots/foot wear doesn't fit properly
More Tape absolutly
Cough Drops haha.. seriously.. .. no better left at home..
*** not on but absolutly needed***
water purification solution
IODINE- can be used for almost everything cut related..
if you have the means to "aquire" this the its a must I.V. sets X2/3

[sql_yoda]

I actually woke up the old lady laughing at this remark:

"Asherman Chest Seals - DONT WORK WORTH A DAMN!! if you ever get the chance to read the directions on the package it states that it must be placed on a clean dry surface for it to stick. i have never known any penitrating chest wound to be either clean or dry"

It's probably not going to be either clean or dry, but the one time I had to do it my materials didn't quite work either. I have no experience with asherman at all, but the only time I ever needed to treat a chest wound that went that deep, I had a sandwich in a plastic baggie - and I ALWAYS carry duct tape. I cleaned the area around the puncture, told the victim to exhale as much as possible and tried to seal it with a glad bag and tape it up... and duct tape doesn't stick all that well to wet skin either. Good thing the hospital was only three minutes away from the ski slope.

Also I couldn't agree more on the immodium comment... you will either need a high colonic or surgery if you dose it wrong... skip it.

[Azraeleternity]

Thank you for this intro to first aid. I'm just starting to build BOB/GHB and IFAK, so this helps me a great deal to know what stuff I'm missing and what stuff I should be replacing with better items because I had no clue prior to reading some of the threads you mention and items you recommend. So thanks!

[FyreWitch]

Surprised nobody has mentioned it -
N-95 respirators, 1 for each group member AT LEAST

Flashlight

As for Immodium, if we are assuming some level of intelligence, handy to have if you might be eating/drinking possibly questionable things. Diarrhea can be fatal or at least incapacitating.

Tylenol - liver poison, If you have aspirin and/or ibuporofen definitely unnecessary.

Saran wrap and duct tape make the best cover for a sucking chest wound. In TEOTWAWKI situation, no point to even trying to save such victim.

If not using a pre-packed minor surgery set, should have hemostats, regular size tweezers and scalpels

I wouldn't carry splints because they are easy to improvise.

I think overall we should be distinguishing here between what would be carried routinely as an everyday first aid kit, what to carry in BOB for 72 hours use and what to have ready in whatever sanctuary destination we have in mind. Big difference in what is needed. If we're in a SHTF situation, advanced medical care may be available at some point in the near future. Therefore things like airway adjuncts and BVM's may have a place. (Note "in the near future" and "may have a place")

Iodine tablets, good idea. Also, if at all possible, Cipro (ciprofloxacin). I know not everyone has access, but if you do, get some. Predenisone, if you have access.

I have asthma but usually only use 2 or 3 inhalers per year. My insurance allows for 1 per month so I get one every month. Anyone with a condition like that should do the same. Some things, sadly, you just can't get more than you actually use - 30 doses for 30 days.

As for the previous comments about doctors - any individual is best at what they were prepared for. Most docs are out of their element in pre-hospital care and should not be knocked for it. There are also plenty of docs that have served in the field in the military or as med-flight doctors. Some people, doctors included, are better at "stepping up" when the situation warrants than others. Outside in a mass disaster is not the same as working inside an ambulance - for doctors or EMT's _ for worse and better. Any emergency, trauma or surgically trained doctor would be useful, a psychiatrist not so much. Keep in mind that OB-Gyn is a surgical specialty and those docs are proficient in pretty much any abdominal surgery. Bottom line - don't judge anyone until you actually KNOW what they can do.

My 2cents.

[FyreWitch]

Don't ask me anything that you couldn't find out quicker from Wikipedia. >_>

Don't trust Wikipedia as a source. All articles are user-generated. Any article is only as good as those who contributed to it. Some are quite good, others loaded with errors.

[Azraeleternity]

Don't ask me anything that you couldn't find out quicker from Wikipedia. >_>

Don't trust Wikipedia as a source. All articles are user-generated. Any article is only as good as those who contributed to it. Some are quite good, others loaded with errors.

I should correct it to "Don't ask me anything that you couldn't find out quicker from Gunny."

[VXMerlinXV]

1) Tylenol - liver poison, If you have aspirin and/or ibuporofen definitely unnecessary.

2) Saran wrap and duct tape make the best cover for a sucking chest wound. In TEOTWAWKI situation, no point to even trying to save such victim.

3) I wouldn't carry splints because they are easy to improvise.

A couple of quick notes:

1) I think Tylenol has a place in most kits. A lot of people can't take Advil, and aspirin has a variety of it's own nasty side effects. Tylonol is also useful in alternating with advil to keep a persistant fever down. The dose has changed, but a lot of people still give it regularly.

2) Have you actually used this method? What other occlusive products have you tried that did not work as well? I can see people maybe prefering it over petrolium gauze depending on their amount of experience, but an ACS, BCS, or Hyfin have serious advantages over Reynolds wrap. As far as the validity of caring for such a pt, there is a thread discussing this matter just a few posts down.

3) I love SAM splints, and prefer them to almost any commercial alternitive for emergency use. Having improvised a variety of splints in the past, I've learned splints are worth the space an weight. I've always got one in the FAK and one in my personal gear.

[FyreWitch]

1. Unless you know that someone is allergic to NSAIDS, IMO, Tylenol isn't a necessity. But, to each his own. Some of aspirin's side-effects are exactly what makes it useful - anticoagulation not Gi Bleed

2. I have seen it used with good results. Just thinking of not carrying things that aren't multi-purpose. I have seen other products work well, too. It's all in experience and what you're most comfortable with. To each his own, again. Sucking chest wounds aren't as commonly encountered as people think.

3. I like SAM splints myself. Just meant splints can be improvised if you want to go bare bones.

I have a very small kit for short hikes and such, a bigger bag plus extras in the car and even more stuff stored in the house. A lot depends upon what you are prepping for and what things you know how to use. I keep some things that may be useful for here and now but would not be in a situation where no advanced medical care would be available in a reasonable. For example, BVM's and airway adjuncts. I think the original advice given was really a pretty good jumping-off point, to add or subtract from as suits your needs.

[RustyMedic]

I agree with most of the statements above except for the Benadryl comment...for a minor allergic reaction I am not going to slam Epi into someone he obviously doesn't need it, their BP is most likely fine and there is no Bronchoconstriction if I am considering Benadryl, Epinephrine in the field is to valuable to be used in a minor allergic reaction. No point in making a patient/soldier tachycardic for no reason when a regular anti-histamine works just fine.

[brothaman]

Great Thread. I'm glad I read it first like the title said. Looks like I've got some books to buy. But I've now got a great start to my FAK.

Immodium - most miss used otc on the market.. plus its really touchy.. take it when you dont really need it and you could become so backed up that you need surgery to correct it.. take too little and all your doing is waisting meds.. wouldnt advise this one

Immodium is the DEVIL. After a night of partying a little to hard it had a touch of the whiskey shits. I took 1 immodium and then I didn't shit for 9 days. I'm a twice a day kinda guy. This was fricken awful.

[ehunter72]

So does that challenge to Doc's go for a trtird Medic and Current Paramedic?

I have ran my lanes (Army medics will understand that), and been a current Paramedic for nearly 20 yrs.
When I worked solely on the Rescue Squad, I went through about 15 EMT's a year, never could stand one that didnt know their lane.

I have taught 6 EMT-B classes, with each class you get about 2 good EMT's, 7 that will never practice a single skill they have learned and about 10 who think they just became the Prehospital Trauma gods.
Out of a full class, 2 might be hired locally. ( I have one graduate now who keeps applying but she will never work, she thinks her shit is swift, she will meet a Doc or Pmed once then start calling them or talking to them like they have been friends forever, uses terminology in a reguliar conversation, she tested pretty good, but she thinks that her 10 pt contacts (the only live people she has ASSISTED in treating) are all alive today because of her, never has done CPR, bagged a pt, stopped a bleeder, but can tell you all about how to do it. Even tried to engage the Medical Director in a conversation on how aour proticols need changing cause the book says.........She will never work in EMS here, nor will she be approved for a Pmed class, locally anyway.




For the most part if your not going on in EMS, take a First Responder class, you will get all the info you want and 1/10 the cost and 40hrs(usually split over weekends) vs a semester.
And the EMT god above, you would not last a week at my agency or the volly dept I am with.


Like someone above said.

(this goes only for a professional setting)

EMT-B, Turn on the O2 and shut up and drive...

[VXMerlinXV]

...A bunch...

I find the best EMT's are the ones who act the most like puppies right out of the gate. If you can get them to quiet down, get the nine tons of junk off of their belt, and learn to watch before they talk or listen, they will generally make good prehospital providers. There is an undeniable adjustment period in a provider's first gig where their preceptors need to help shape their practice, and bridge the gap from class to field, which IMHO is the most important part of EMS education.

[ehunter72]

Very True,Very true.

But he old addage, "you can lead a horse to water" comes to mind......

I will admit one thing, in teaching, and assisting in classes locally, you get your pick of the litter. You also get a heads up on the runts. ( I don't do the hiring at my agency and being a FF is kinda manditory, I do have a good deal of input though))I have begged students to apply after certification, knowing they have what it takes, only to hear, " I just took the class for myself- I have a job" or " I have no desire to take a pay cut, I took the class to be prepared".

I have sat many a student down after class and had the "talk" with. Sat many new EMT's down after a few shifts and had the talk. sometimes it works and sometimes it doesnt.

Precepting a "student who refuses to get it", its like the 55 yr old Smoker, on O2, with one lung and a trach,smoking a camel non filter that calls for "difficulty breathing", I am sorry mame, I cant fix in 10 minutes what you took 40 yrs to break....

[full on]

howdy i am assembling stomp bags and you have the only listing for packaging and contents i can not find the packing list for the hemmorage kit and would like some help also i have much extra medical supplies and stomp bags and ifak looking to trade or buy airway kit accesory pouches for stomp and burn kits thank you for all the tme you have spent on the contents and packaging details way more help than nar and blackhawk

[Darxus]

2 Rolls of Kerlix or similar Gauze

Please modify this to something like: "2 Rolls of Kerlix / PriMed compressed / Z-Pak or similar gauze"

I was so distracted by the frothing over Kerlix that it took me a lot of looking for Kerlix and random other reading on the subject before I realized there were better (same, but more compact) options. Which are recommended all over this site, but not here, where it matters most.

[run faster]

I dont know jack about first aid, but Im trying to learn, but its really freaking hard lol. Im getting woozy just sitting here reading and thinking about blood and needles.......

[Nobody]

Wow. Now I know why I left this subforum in the first place. I should never have looked looked back.

[Poboyspecial]

Love the information.... Awesome!

I just want to add 2 things to be considered.
1. Lye soap = It is great for poison ivy, cleaning wounds, greasy hands, laundry, and many more useful applications.
2. Preparation H = It is wonderful for burns, itching, and great for sunburn (yes, really) Try it!

Just a suggestion on 2 things I have found to be very useful.