POINT 1: KITS, MODULES AND CUSTOMIZED SERVICE:
So here's our first point, and the central point of this post: Anything with "kit" in the product description is probably (almost invariably) going to fall into one or more (sometimes all) of the following categories:
a) It's grossly overpriced for what is actually inside, and you're paying for labor and convenience;
b) It's padded out with a lot of items that are unnescessary and/or don't fit the purpose of the kit;
c) It's lacking one or two core items that the company tells you to "just add";
Now, very occasionally you WILL find a pretty well thought out kit that is carefully designed - Adventure Medical Kits and Rescue Essentials both have some like this - but you must STILL remember that you are paying extra money and also sacrificing extra space/weight for the sake of convenience. My general advice to anyone wanting to start a medical bag is: roll your own.
The cousin of the "kit" is the "module". A module, in the medical supply sales sense, is a group of items that have been selected and packaged together to perform a specific job - as opposed to a kit which is more of a catch-all. Excellent examples of what I'm talking about can be found at Chinook Medical - you'll notice that all of this stuff is geared towards a specific task, there's burn modules, airway modules, foot care modules etc. So how do these weigh up?
The answer, truthfully, is - not great. Whilst buying a selection of "modules" will generally get you a more streamlined and advanced set of gear over buy a "kit", you will notice three things when all done:
a) You will have spent a LOT of money on convenience and organization - modules, even more so than "first aid kits" tend to have a very, very large markup over materials cost;
b) You will have quite a lot of overlaps and multiples - especially on PPE and instruments;
c) As a beginner, you'll probably end up with a good portion of gear that you don't know how to use - especially with airway modules;
Now one glaring advantage that "modules" do have is that having a selection of them does give you instant and extensive organization - this can be a good thing of course (especially if your bag/container doesn't feature much in organizational options), but over time as your kit grows and you go through different bags and carry systems you'll want to organize things differently, to suit yourself. For this reason I generally don't suggest buying your whole kit modular - but I freely admit that I do run a few modules because they ARE convenient. My general rule is; if the items in the module would be packed up together in a ziplock on my end anyway AND it is nonemergency AND the price difference between the module and the items in the module is worth equal to or less than 15 minutes of my time, I will buy the module. For me this means dental, foot care and booboo kit are modules.
Finally in this section we have the evil cousin of the family... the "customized for you" kit. Many (most?) online rescue/tactical medicine equipment providers offer this service - they'll put a kit together tailored to your own needs. Okay - people - this is like paying someone to change your oil, if you just can't be bothered to get underneath your truck for 10 minutes with a simple tool then by all means, pay someone else to do it - but do not think that they're doing it for free because they're not. Just stay away from this kind of service unless someone else is paying or money doesn't mean anything to you - but for 95+% of users this is a bad idea.
POINT 2: SO WHAT DO I GET THEN?
Well, first thing is first - to quote Doc Simon in his sticky;
If your first aid kit doesn't have the following items dont even bother asking for suggestions!
That's right, if you dont have this stuff all you are going to get in reply are the things on this list. (This is a bare minimum, more is recomended)
2 Rolls of Kerlix or similar Gauze
2 Ace Wraps
1 roll of one inch tape
1 roll of 3 inch tape/duct tape
This is very, very solid advice.
If you can't stop bleeding, then there's no point in having anything else. Little timmy doesn't give a fuck about having his blister taken care of if he's bleeding to death. The number one problem I see with most prepackaged "kits" is that they do not have NEAR enough supplies for massive trauma - most of them are 80% booboo and snivel gear and 20% lifesaving gear, even in kits purchased on "tactical medicine" sites.
The rule of thumb is; start big and work down, and I have a special system of wound assesment that I have designed for newcomers to simplify patient assement; I like to call it the "Ista Scale". (LOL GET IT? BECAUSE IN LAKOTA "ISTA" IS PRONOUNCED "ISHTA" WHICH SOUNDS LIKE "RICHTER" AS IN "RICHTER SCALE"?? HAHA LOL NOBODY GETS IT BECAUSE ONLY LIKE TWELVE PEOPLE IN THE WORLD STILL SPEAK LAKOTA LOL I'M HILAROUS! WHATEVER MAN...)
The Ista Scale goes like this:
IL4: FUCK! - Massive trauma, RTA/GSW/Etc, airway management
IL3: ARGH! - Serious bleeds, serious burns, fractures
IL2: SHIT! - Deeper cuts, small burns, sprains
IL1: OW! - Minor scrapes, blisters, foreign bodies
This is, of course, a little tongue in cheek - but it serves to illustrate my point, which is: when you're buying stuff for your new kit - think about the worst case scenario that you a) are likely to encounter and b) have the skills to treat, get that stuff purchased/in your shopping cart, and then work down. If the first thing in your basket is a package of knuckle bandages then you're doing it wrong - think of outfitting a medical kit just like any other project, you have to have a system in mind with which to approach the project or you're going to get lost, forget stuff and probably overspend too. Be organized, have a plan of attack and STICK TO IT - if you see something that you want or think "hey that might be useful" then think about where it fits in, if it's nescessary and where you're going to keep it.
Second rule of thumb (arguably the first but if you don't have supplies then it don't really matter): If you can't help yourself then you can't help anyone.
This is where your personal protection gear fits it - both medical, like gloves, eye shields etc. and - environmental. How many of you have trauma kits in your car in case of an RTA? Okay, and how many have a high vis orange vest, road flares and safety triangles in there too? How many of you have active shooter response kits? And how many of those people have a concealed carry permit? It's very, very important when you're putting a response kit together to think about the intended theater it'll be used in and how you can prevent YOURSELF from becoming a casualty while you're trying to help someone else - not only because you should be concerned with your own safety but also because if you're dumb about it you can easily turn one patient into two for those responding after you.
And so, I'm going to paraphrase Doc Simon's above post and make my own to fit this;
If your first aid kit doesn't have the following items, stop and ask yourself wtf you are doing!
2 Pairs of exam gloves
1 Pair eye protection
1 N95 or procedure mask
1 Blaze orange vest
Third rule of thumb: if you can't find it, you can't treat it:
If your first aid kit doesn't have the following items, stop and ask yourself wtf you are doing!
1 Portable light source, preferably hands free
1 Clothing cutting tool - EMT shears, Benchmade style "hook" etc.
1 Bottle irrigation/washing fluid
So what does all this mean? Simply put - it means that the foundation of a solid medical kit shouldn't even look that medical, the foundation of a good medical kit is personal protection, patient access and massive trauma treatment. Even more simplified, to really drum this in, the whole of this section can be summed up thus:
YOU NEED TO BE ABLE TO SAFELY AND QUICKLY TREAT LIFE THREATENING WOUNDS.
AFTER that, you can start picking up other stuff to make your bag start looking more comprehensive. Nobody gives a shit if you have a pulse oximeter if you don't have a tourniquet.
POINT 3: SO HOW DO I SHOP THEN? LIKE WALK ME THOUGH THIS...
The first things in your shopping basket, without any deviation whatsoever, should be:
1 Portable light source, preferably hands free
1 Clothing cutting tool - EMT shears, Benchmade style "hook" etc.
1 Bottle irrigation/washing fluid
2 Pairs of exam gloves
1 Pair eye protection
1 N95 or procedure mask
1 Blaze orange vest
2 Rolls of Kerlix or similar Gauze
2 Ace Wraps
1 roll of one inch tape
1 roll of 3 inch tape/duct tape
After that, you're looking to treat severe blood loss:
1 Tourniquet
2 Emergency Trauma Dressings (Izzy/NARP/OLAES/Whatever, don't matter)
Moar Gauze! H&H/Kerlix etc
1 Hemostatic gauze product - QuikClot Combat Gauze, CELOX Trauma Gauze etc.
At the same time, you need to help people breathe:
1 Set NPAs and don't forget the lube
1 Chest Seal or ability to improvise one
1 Suction device (cut down turkey baster or syringe works)
1 Pair Magill Forceps
Then, and only then, you can start thinking about the following two questions:
1) What can I add to that to further expand those capabilities within my scope of practice?
2) What else do I want to be able to treat, in what order of importance?
POINT ER... WHATEVER I LOST COUNT:
Okay so now you're on your way to having your very own medical kit and/or extremely expensive hobby/moneysink - now I'll merely impart a few tips and wisdoms, and wish you luck from there on out.
1) Do not buy a bag and then try to fill it. Buy your kit and then buy a bag to suit it. You don't want to have a bunch of shit you don't need just to make the bag look good in the hot or not thread.
2) Keep it organized - you want to make sure that if/when you need that bag for a real situation you know where everything is and how to get it quickly. Keep your cutting and lighting tools on the top/outside.
3) If it's "tactical" it's probably overpriced. You'll find you can save a LOT of money by getting non "combat" based products from actual medical supply companies and/or pharmacy departments rather than just buying everything including 4x4s from a tactical/rescue medicine site.
4) eBay is your friend. Obviously exercise some caution and buyer beware of things like expiration dates and OEM manufacture but you can and will save a LOT of money by carefully watching eBay, especially for things like bags, instruments and HemCon bandages.
5) If you don't understand how to do something, there's very little point in having the gear to do it unless you're likely to be trained on it soon (or you know/live near/shoot/camp with someone who can but doesn't prep). Don't waste money, space and weight on things that you just think will look cool on the forums. Someone who shoots his Mosin Nagant every day will beat someone who has a KRISS Super V they've never taken out of the safe.
6) Don't be cocky around here. A lot of people on this First Aid forum are seriously squared away and have a lot of knowledge to share - we also tend to be one of the most low bullshit tolerance forums on ZS and if you act like a prick and/or pretend you're something you're not then we will get pretty militant. If you have questions then ASK, read the stickies, lurk for a while so you can tell who the respected posters are and then jump in.
7) If you don't have at least basic Red Cross first aid training then you are in the wrong place, you should be in class. Furthermore, as an ancillary to poing 5) if you are carrying shit that you think is cool and are "pretty confident I know how to use" then you are doing it wrong. If you want to be carrying something advanced that bad then you should want to learn how to use it safely too - poorly trained/educated people can and do make situations WORSE sometimes, no matter how hard they're trying to help.
8 ) A combination of 6) and 7) is: if someone who knows more than you does gets on scene (or in forum) then have the sense and respect to stand down and play second fiddle. Medicine isn't about dick sizing (or shouldn't be) - you might be feeling like the highest speed, lowest drag motherfucker on the planet when you're crouching over that patient with your STOMP bag and everyone is looking at you like you're superman but remember, it's time to stand down and be humble when someone better trained comes along, even if it's a 60 year old female nurse - stand aside, offer her your kit and assistance and don't get in her way. If you're in this field for glory, you're in the wrong field.
