Any other medics dumbing down their kits?

Discussions of the best (or worst) equipment to have on hand for use in the event of an injury during an emergency.

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OLM-Medic
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Any other medics dumbing down their kits?

Post by OLM-Medic » Fri Mar 23, 2012 11:34 pm

I used to have all of the fancy gadgets and medications in my kit. Now I'm realizing how dumb I was.

First I will talk about the STOMP pack. It surely isn't the best designed pack ever, especially the original version I have, but no medic pack is. They always seem to have a bunch of useless organizers that end up limiting your options. My former pack had all kinds of fancy crap, medications, suction unit, intubation kit, 4 IV bags etc. Not anymore...

I feel like the more you know, the less you need. I don't mean less equipment, but less advanced crap that isn't going to help. I ditched nearly all of the meds. I have a small pencil box now that has [legal] pain meds prescribed to me, tylenol, ibuprofen, benadryl, and epi. I keep the epi because giving random antibiotics and pain meds when SHTF comes could cause an allergic reaction...so could numerous encounters in the woods. I also ditched the manual suction, which I couldn't justify due to its poor efficiency. I sized down to just 2 1liter IV bags. I got rid of a lot of other junk but I still kept the intubation kit and bag valve mask.

After all of this junk was gone, I replaced it with as much trauma supplies as possible. Tape, sterile kerlix, kerlix, cravats, abdominal pads, and more 4x4's than you could imagine. I also added some mild soap, and a saline solution to irrigate in the field if needed. I have a medication organizer full of antibiotics that will go in the pack when the time comes, but its in the refrigerator now (to prolong shelf life).

I have realized that trauma supplies are going to be a big concern if your version of SHTF includes other people having weapons. Treating wounds "long term" will take tons of bandage changes...more than you would think. Also, a lot of the other fancy crap will not help. I could even justify getting rid of my intubation kit in favor of a smaller cric kit...but I can't part ways LOL.

I don't like carrying the STOMP at all, and would probably just keep it for a mobile MCI kind of set up, or a setup in a vehicle. I carry a M3 medic bag, which I do have more "advanced things". Cric kit goes in there along with QuickClot, combat tourniquets and all of that jazz. Also, the BOK has plenty of fancy stuff too. In the long run though, I think a lot of the focus should be with filling duffel bags full of trauma supplies.

What about you guys?

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Re: Any other medics dumbing down their kits?

Post by TacAir » Sat Mar 24, 2012 1:24 am

Ah, yup.

No certification, no carry.
I cringe when I see folks with NPAs, intubation gear, sutures and the like and then ask "How do I use this stuff?"

What did that old school oath say? "First, do no harm?"

I'll admit most of my time as a 'field medic' was spent working in the ER - a different set of procedures and such, but still - the first thing in any kit should be training --refresher, upgrade or continuation.

/soapbox....
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Re: Any other medics dumbing down their kits?

Post by banghowdy » Sat Mar 24, 2012 1:29 am

can you guys make some first aid training videos?

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Re: Any other medics dumbing down their kits?

Post by TacAir » Sat Mar 24, 2012 2:15 am

banghowdy wrote:can you guys make some first aid training videos?
No. But your local Red Cross would be happy to have you in one of their frist aid training classes.

Most Community Colleges offer more advanced training course, some with college credits.
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Re: Any other medics dumbing down their kits?

Post by KMAC179 » Sat Mar 24, 2012 2:38 am

Your most important tool is between your ears. Everything else is extra. Keep it simple. Know your expected casualties, and what wounds you are expecting to encounter.
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Re: Any other medics dumbing down their kits?

Post by cap6888 » Sat Mar 24, 2012 7:38 am

OLM-Medic wrote:I feel like the more you know, the less you need.
I would agree with this statement. For "most" injuries, BLS supplies are more than enough. If you need advanced airways, large volumes or medications in a SHTF scenario the patient probably won't survive anyway. There will be no follow up definitive care available. As medics we provide stop gap measures to prevent death. If we don't get hem to an ER, they more than likely will end up dying.

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Re: Any other medics dumbing down their kits?

Post by banghowdy » Sun Mar 25, 2012 1:41 am

TacAir wrote:
banghowdy wrote:can you guys make some first aid training videos?
No. But your local Red Cross would be happy to have you in one of their frist aid training classes.

Most Community Colleges offer more advanced training course, some with college credits.

thank you for the useful information. it means a lot!

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Re: Any other medics dumbing down their kits?

Post by TacAir » Sun Mar 25, 2012 2:07 am

banghowdy wrote:
TacAir wrote:
banghowdy wrote:can you guys make some first aid training videos?
No. But your local Red Cross would be happy to have you in one of their frist aid training classes.

Most Community Colleges offer more advanced training course, some with college credits.

thank you for the useful information. it means a lot!
??
I'm not being rude, the last place you should consider for 'training' sources is from the 'net. If you take local classes the content will comply with YOUR Local laws/rules and such.

If you don't knowwhich classes are appropriate, check with your State licensing agency for school they recognize as meeting the licensure requirements for your State.

If you take advanced training, have some way to get continuation or update training.
Last edited by TacAir on Sun Mar 25, 2012 11:53 am, edited 1 time in total.
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Re: Any other medics dumbing down their kits?

Post by ProstheticWeasel » Sun Mar 25, 2012 10:27 am

TacAir wrote:
If you take advamced training, have some way to get continuation or update training.
This should be stressed for any training not just medical. Every field of study is changing more rapidly than ever and what may have been the accepted practice a year or two ago is now considered dangerous.

If you try to get information from the internet you will have to spend as much time vetting the source as you would just getting the training from a reputable source. The internet is a good source for ideas but for something like first aid you can make a bad situation worse with something that seemed like a good idea.

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Re: Any other medics dumbing down their kits?

Post by croaker260 » Sun Mar 25, 2012 1:18 pm

OLM-Medic wrote:I used to have all of the fancy gadgets and medications in my kit. Now I'm realizing how dumb I was.

First I will talk about the STOMP pack. It surely isn't the best designed pack ever, especially the original version I have, but no medic pack is. They always seem to have a bunch of useless organizers that end up limiting your options. My former pack had all kinds of fancy crap, medications, suction unit, intubation kit, 4 IV bags etc. Not anymore...

I feel like the more you know, the less you need. I don't mean less equipment, but less advanced crap that isn't going to help. I ditched nearly all of the meds. I have a small pencil box now that has [legal] pain meds prescribed to me, tylenol, ibuprofen, benadryl, and epi. I keep the epi because giving random antibiotics and pain meds when SHTF comes could cause an allergic reaction...so could numerous encounters in the woods. I also ditched the manual suction, which I couldn't justify due to its poor efficiency. I sized down to just 2 1liter IV bags. I got rid of a lot of other junk but I still kept the intubation kit and bag valve mask.

After all of this junk was gone, I replaced it with as much trauma supplies as possible. Tape, sterile kerlix, kerlix, cravats, abdominal pads, and more 4x4's than you could imagine. I also added some mild soap, and a saline solution to irrigate in the field if needed. I have a medication organizer full of antibiotics that will go in the pack when the time comes, but its in the refrigerator now (to prolong shelf life).

I have realized that trauma supplies are going to be a big concern if your version of SHTF includes other people having weapons. Treating wounds "long term" will take tons of bandage changes...more than you would think. Also, a lot of the other fancy crap will not help. I could even justify getting rid of my intubation kit in favor of a smaller cric kit...but I can't part ways LOL.

I don't like carrying the STOMP at all, and would probably just keep it for a mobile MCI kind of set up, or a setup in a vehicle. I carry a M3 medic bag, which I do have more "advanced things". Cric kit goes in there along with QuickClot, combat tourniquets and all of that jazz. Also, the BOK has plenty of fancy stuff too. In the long run though, I think a lot of the focus should be with filling duffel bags full of trauma supplies.

What about you guys?
I just had this discussion yesterday to a new EMT student. My response is "The less I carry, the less I can get in trouble with".

I carry a pocket face mask with filter, gloves (lots of gloves), syranerap (sp), some misc dressings and cravats. I can handle the initial ABC's with that, just like any other well intentioned bystander.

There are a few other things I carry for my own family,. but even then this isnt a lot.
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Re: Any other medics dumbing down their kits?

Post by ppfd » Sun Mar 25, 2012 3:34 pm

Been a Paramedic/Firefighter 22 years
ED RN part time for the last 5 years.

I've got half a box of gloves and I think a pocket mask in my pick up.
Some band aids in the medicine cabinet.

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Re: Any other medics dumbing down their kits?

Post by Corpsman86 » Mon Mar 26, 2012 10:13 am

My philosophy is very simple. Gloves, broad spectrum antibiotics, suture kits, alcohol, and gauze. Everything is is luxury and impractical in a shtf situation.
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Re: Any other medics dumbing down their kits?

Post by blackmesa » Mon Mar 26, 2012 6:53 pm

Corpsman86 wrote:My philosophy is very simple. Gloves, broad spectrum antibiotics, suture kits, alcohol, and gauze. Everything is is luxury and impractical in a shtf situation.
Antibiotics and surgical equipment are pretty much the opposite of simple :lol:

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Re: Any other medics dumbing down their kits?

Post by OLM-Medic » Mon Mar 26, 2012 7:09 pm

In my car I carry a small trauma kit in an M3 bag and a bag valve mask (just bc I don't like mouth to mouth...even with the pocket masks). Whenever a pull over to a scene and some EMT is there and says frantically "YOU HAVE A NECK COLLAR AND A BLOOD PRESSURE CUFF IN YOUR KIT?" I just laugh inside a little.

Now don't get me wrong I have some airway stuff and I'm trained to use it, as well as antibiotics, but I think a lot of stuff is just useless.

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Re: Any other medics dumbing down their kits?

Post by PotatoMuncher » Tue Mar 27, 2012 9:03 am

I wouldnt say Ive been dumbing down my kit. Its more like I'm attempting to do more with less. No point in carrying some fancy new laryngoscope when you can replace it with more tylenol, gauze or alcohol pads. New supplies are cool and all, but they have their time and place, and in a jump bag is not it, especially in a SHTF situation.

As for a bag, I've actually been designing my own bag for my own use, tailored to myself and how I want it set up. I've never been truely satiafied with a bag before, but I've come close. The TSSI M9 bag is as close as Ive come with being happy.
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Re: Any other medics dumbing down their kits?

Post by cap6888 » Tue Mar 27, 2012 9:34 am

PotatoMuncher wrote:I wouldnt say Ive been dumbing down my kit. Its more like I'm attempting to do more with less. No point in carrying some fancy new laryngoscope when you can replace it with more tylenol, gauze or alcohol pads.
That is a neat trick.......although I can't fathom how to pass a tube by just using Tylenol, gauze, and alcohol pads. :mrgreen:

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Re: Any other medics dumbing down their kits?

Post by PotatoMuncher » Tue Mar 27, 2012 9:50 am

cap6888 wrote:
PotatoMuncher wrote:I wouldnt say Ive been dumbing down my kit. Its more like I'm attempting to do more with less. No point in carrying some fancy new laryngoscope when you can replace it with more tylenol, gauze or alcohol pads.
That is a neat trick.......although I can't fathom how to pass a tube by just using Tylenol, gauze, and alcohol pads. :mrgreen:
Well, it involves a lot of the patient's spit and cooperation.
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Re: Any other medics dumbing down their kits?

Post by T-Boon » Tue Mar 27, 2012 10:08 am

Basic first aid kit in all my cars, so I`m never far away.
Off the shelf covers most basic needs, most i`m likely to do anyway is, clean, gauze bandage, stop bleeding and monitor, then a good handover to the higher medical responders.

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Re: Any other medics dumbing down their kits?

Post by ptAltered » Wed Mar 28, 2012 7:40 pm

Absolutely!

The aid that we administer in austere conditions, say in the backcountry of a Third-World nation, on a friend or family member is vastly different than "street medicine". Certain medical conditions require such specific, singular use items for their management that their onset is frequently fatal. An example is Insulin; it's a life-saving intervention for a diabetic emergency yet it's got no other purpose, degrades quickly outside of it's ideal storage temperatures and requires a companion device (a BGL) to be effective. An issue that could quickly be addressed in the back of an ambulance, or even on scene from an ALS bag, could turn out fatal in these circumstances. People with a history of diabetes, asthma, anaphylaxis, seizures or heart conditions should carry their own medication that a responder could use to aid them.

It's not reasonable to expect anyone but professional SAR medics to come equipped enough into the back country that they can handle these specific medical conditions while evacuation takes place.

My trauma gear is carried to deal with a few specific life threats; compromised airway, massive hemorrhage, tension pneumo. This lives in my larger medical kit that's set up to manage small injuries (blisters, burns up to partial thickness on small parts of the body, hygiene related), perform wound closures (irrigation syringe, Steri-Strips, CTB, DermaBond), splint injured bones (SAM splint, cravats) and perform a basic assessment (trauma shears, pen light, PPE, notebook). Under my W-EMT protocols I can, when acting as a responder with my rescue group, carry and administer multi-dose epi, ODT Zofran, Benedryl, Aspirin, D50 and Narcan. I also carry ibuprofen, immodium and 20 5mg Oxycodone (Percocet). If the actual shit did hit the fan I'd probably start carrying some IV start sets and bags of NS.

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Re: Any other medics dumbing down their kits?

Post by blackmesa » Thu Mar 29, 2012 5:19 am

ptAltered wrote:20 5mg Oxycodone (Percocet).
Mo
Why carry oral oxycodone instead of IV morphine for acute care?

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Re: Any other medics dumbing down their kits?

Post by Jorian » Thu Mar 29, 2012 3:01 pm

ptAltered wrote:It's not reasonable to expect anyone but professional SAR medics to come equipped enough into the back country that they can handle these specific medical conditions while evacuation takes place.
QFT. A good paradigm to keep in mind during any "paring down" process.

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Re: Any other medics dumbing down their kits?

Post by Krustofski » Thu Mar 29, 2012 6:06 pm

Am I the only one who read this as "dumbing down their kids" at first glance? :lol:



I do not deliberately "dumb down" kits, it happens more or less inadvertently.

Lately, I found myself weighting the actual propability to use an item & the benefits it would bring me if I used it against bulk & weight.

A laryngoscope alone is useless without blades & and an assortment of ET tubes. Should I really bother with all that? I mean, I'm trained to use it, and sure, endotracheal intubation is the only practical method to _really_ secure an airway, but shouldn't an NPA or OPA do the job 99% of the time?
Look at it that way: Say a patient needs ventilation. If infratstructure in in place, an ambulance can reach me within 20 minutes (more like 3 minutes with the fire station down the road, but, you know, worst case scenario). I think I can get some air into his lungs for 20 minutes using an OPA or NPA & a bag 99 % of the time. After that, he's the ambulance crew's problem, not mine. If there is no infrastructure to help my patient (the TEOTWAWKI situation we all keep talking about), and he requires intubation & ventilation... well, he's screwed anyway. What am I supposed to do if I can't get him to the ICU? Bag him for all eternity? Just great, should I also put in a PEG while I'm at it? No? So why bother with laryngoscopes & ET tubes in my situation? If I just take a few sizes of NPAs, I can use the space I just freed for more 4x4s, because you can NEVER have enough gauze pads.

The same goes for carrying three IV lines, a dozen different PVCs & three liters of fluids. I understand the need for this in case of bleeding or diarrhea, but in most other cases, volume replacement can be done up the arse. So out with most of it, keep one bag, one line, and a selection of PVCs. Look daddy, a lot of space for more gauze pads!

What I'm trying to say is: No, I do not dumb my kit down & deliberately remove things that need a lot of training to use. But the things I throw out because of size & weight considerations just so happen to be the fancy stuff. Which I still own, it just resides in a box in my closet all the time.

Also, everything I said above of course applies to my situation in a major civilization hub. If you're out in the sticks & it takes the nearest ambulance 60 minutes to reach you on a good day, things will be different.

It is 1 am. How can this be? I need to go to bed in, like, -2 hours.
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Re: Any other medics dumbing down their kits?

Post by prtp3warrior » Fri Mar 30, 2012 8:22 am

croaker260 wrote:
OLM-Medic wrote:I used to have all of the fancy gadgets and medications in my kit. Now I'm realizing how dumb I was.

First I will talk about the STOMP pack. It surely isn't the best designed pack ever, especially the original version I have, but no medic pack is. They always seem to have a bunch of useless organizers that end up limiting your options. My former pack had all kinds of fancy crap, medications, suction unit, intubation kit, 4 IV bags etc. Not anymore...

I feel like the more you know, the less you need. I don't mean less equipment, but less advanced crap that isn't going to help. I ditched nearly all of the meds. I have a small pencil box now that has [legal] pain meds prescribed to me, tylenol, ibuprofen, benadryl, and epi. I keep the epi because giving random antibiotics and pain meds when SHTF comes could cause an allergic reaction...so could numerous encounters in the woods. I also ditched the manual suction, which I couldn't justify due to its poor efficiency. I sized down to just 2 1liter IV bags. I got rid of a lot of other junk but I still kept the intubation kit and bag valve mask.

After all of this junk was gone, I replaced it with as much trauma supplies as possible. Tape, sterile kerlix, kerlix, cravats, abdominal pads, and more 4x4's than you could imagine. I also added some mild soap, and a saline solution to irrigate in the field if needed. I have a medication organizer full of antibiotics that will go in the pack when the time comes, but its in the refrigerator now (to prolong shelf life).

I have realized that trauma supplies are going to be a big concern if your version of SHTF includes other people having weapons. Treating wounds "long term" will take tons of bandage changes...more than you would think. Also, a lot of the other fancy crap will not help. I could even justify getting rid of my intubation kit in favor of a smaller cric kit...but I can't part ways LOL.

I don't like carrying the STOMP at all, and would probably just keep it for a mobile MCI kind of set up, or a setup in a vehicle. I carry a M3 medic bag, which I do have more "advanced things". Cric kit goes in there along with QuickClot, combat tourniquets and all of that jazz. Also, the BOK has plenty of fancy stuff too. In the long run though, I think a lot of the focus should be with filling duffel bags full of trauma supplies.

What about you guys?
I just had this discussion yesterday to a new EMT student. My response is "The less I carry, the less I can get in trouble with".

I carry a pocket face mask with filter, gloves (lots of gloves), syranerap (sp), some misc dressings and cravats. I can handle the initial ABC's with that, just like any other well intentioned bystander.

There are a few other things I carry for my own family,. but even then this isnt a lot.
Most of my experience is in a semi wilderness setting and I agree about having more trauma stuff and less gadgets.

I also agree to an extent about the less I have the less there is to get in trouble with....I carry zero internals.

On the other hand, sometimes in my position I find myself as a little bit of a pack mule. When something serious happens i really have very little time to actually deal with the patient anyway as most of my time is spent trying to organize an evac. Fortunately in my field, I am not getting shot at while attempting it...but I digress.

I have found a couple of times when a nurse or medic happened to be around and offered Samaritan assistance. Usually they have no supplies with them as they are just out for liesure. In these cases, I was glad to have things such a BPC and such that, though I can use, I seldom have time too. It just allows us to gather more info to relay to the guys taking them out or whatever.

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Re: Any other medics dumbing down their kits?

Post by Jamie » Fri Mar 30, 2012 8:30 am

I go backcountry camping every month, and always bring a FAK...I'm not a medic, but I have FA training from the RC and Wilderness First Responder training from a school in my area...

When I first joined/found ZS, I read a ton, and added all sorts of crap to my FAK based on threads in this forum. A couple of years later, I'm back to a pretty lightweight FAK that can cover the most common injuries/ailments I encounter in the backwoods, and can stretch to include pretty significant injuries...it weighs under a pound and fits in a small ditty bag.

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