Darxus' IFAK

[Darxus]

This is a FAK intended for just myself, to go with a light pack for long term foot travel (significant improvements since the first post). I know it's kind of silly to mention fiction, but I think the situations in the movies The Road and The Book of Eli are useful for how I think it's best to pack.

Last month was the first time I got off my ass and went on an overnight backpacking trip. Alone, with a few bandaids, duct tape, super glue, and some pain killers. Then went out again with my girlfriend and basically the same stuff. I warned her ahead of time I felt negligent in my first aid preparations.

In addition to the main FAK, I'm putting together a loaner FAK to toss in my girlfriend's pack or whoever I'm hiking with in case they don't have stuff. They'll both live in my car. I plan to keep more in my car and my house eventually, but not there yet. Wouldn't mind hearing experiences with the later two - I heard one guy had problems with the PriMed losing vacuum (concern only for bulk, not sterility). Z-Pak stuff looks more durable, but I have no info.

I'd like feedback. Especially if anybody has ideas better suited to long term, light weight, low bulk. This is important enough for me to re-word: If you were going to spend the rest of your life carrying all your worldly possessions on your back, what first aid gear would be worth carrying, when you also have the weight and bulk of four seasons of not-dying-of-hypothermia gear packed? An Izzy and two large rolls of gauze aren't going to last me a life time. Yet I'm really doubting it's worth carrying more, for a life time.

I included where I ordered stuff from because I found it to be a real pain to find everything without spending crazy amounts on shipments from multiple places.

Stuff I have packed:
duct tape (need more, 3 yards re-rolled?)
elastic (ACE) bandage, 3"x5.3'
super glue (closing wounds)
pain killers (ibuprofin / advil / motrin, naproxen / aleve, acetaminophen / tylenol)
Loperamide (Immodium, anti-diarrheal)
mole skin
neosporin (antibiotic to accelerate wound healing)

I own, but need to find:
EMT shears

Ordered from http://www.rescue-essentials.com/ (shipping was much better than chinookmed.com)
Israeli bandage, 6" (NSN 6510-01-492-2275)
PriMed Compressed Gauze x2 (NSN 6510-01-503-2117)
SAM splint, 36" (grey) (NSN 6515-01-225-4681)
Rehydration salts (WHO), for 1 liter x2 (NSN 6505-01-197-8809)
Tincture of Benzoin, 1 ampule - good for taping to bloody mess, and blister care?
triangular bandage (cheap)

Ordered from Amazon: (free shipping)
bandaids (Nexcare heavy duty water resistent assorted, Band-Aid heavy duty waterproof large)
butterfly sutures (3M steri-strips)

Still need to buy:
a couple 3"x3" gauze pads (to reduce need to break into large gauze)
1" tape, Durapor - ("under the name 3M Nexcare HD Durable Cloth Tape - Hospital Name: 3M Durapore Surgical Tape for $2.19")


Loaner FAK: (mostly ordered)
Israeli bandage, 4" (NSN 6510-01-460-0849)
PriMed Compressed Gauze x2 (NSN 6510-01-503-2117)
duct tape
triangular bandage (cheap)
bandaids
butterfly sutures
immitation SAM splint, 36" (orange)
Tincture of Benzoin, 1 ampule
Should probably add a ~4" ACE bandage and Durapore


Chest seals sound fun, but I'm thinking the chances of me needing them and the rest of the necessary medical care being available are low enough to not be worth the cost / bulk / weight. I need to find out the recommended treatment for a sucking chest wound without a chest seal is though.

I really want a Combat Application Tourniquet (NSN 6515-01-521-7976). It's Amazon's first recommendation for me at the moment. I'd been doing a good job of not ordering one, again on the grounds that if I need it, the patient is probably going to die of lack of a hospital anyway. But they make such sexy belt pouches for them. And then I read Twich231's post about saving a life with an improvised tourniquet. Damn him. Well, he did fine without a purpose made tourniquet.

I'm interested in opinions on getting a couple suture packs like these. I have no training. I've watched a few youtube videos of people stitching up oranges, and I'm up for practicing that a few times. And for the bulk / weight, seems likely enough to be useful in a PAW situation.

I'm tempted to get a QuikClot Sport 50g teabag. Not entirely convinced it's worth the $15. CELOX looks more expensive.

I'm probably most conspicuously short on wound disinfectant. Betadine, chorinehexidine digluconate, 50ml irrigation syringe, iodine prep wipes? No way I'm carrying sterile water - any point in carrying an irrigation syringe for use with filtered surface water? Seems like it could be useful for long term re-usability, cleaned thoroughly between uses, after running out of recommended options. Yeah, go ahead and twitch, but tell me, after you run out of sterile options and hospitals, that you wouldn't be glad to have a non-sterile but washed irrigation syringe.

I want to get a shemagh, 42" cotton square (versatile desert headwear), to replace the triangular bandage, for versatility. But I haven't come to terms with packing cotton in New England, and nobody seems to make them out of Merino yet.

I had been planning to go with Gatorade powder instead of rehydration salts, but the convenient packing won. I guess Gatorade makes very similar packets, but they cost more, and I'm more likely to eat them inappropriately. I have a sugar problem.

When are nasopharyngeal airways useful? I mean, I get the idea, but when would I really end up using one?

There's a good chance this will get heavily re-factored when I have all my ordered stuff in hand.

I'd really like someone to take a photo comparing 4.5" (large) Kerlix, PriMed compressed gauze, and Z-Pak gauze, for the wiki. My impression is that they're equivalent, and the later two are a great idea for those of us sensitive to bulk. And can somebody verify that when you folks mention Kerlix, aggravatingly neglecting to mention the size, you're generally using the 4.5" x 4.1 yard stuff (model 1892 / 3324), which happens to be the same dimensions as PriMed and Z-Pak, and conflicting with the sticky that says 2.25"?


I've been Red Cross First Aid and CPR certified a couple times, not current. I'm interested in some EMT training, maybe volunteering, hell, it might be a good career direction for me (although a major pay cut), but school was a seriously traumatic experience for me, and so getting that kind of training sounds pretty terrifying. I live in Southeast New Hampshire. Manchester isn't terribly far from me. I'd appreciate specific suggestions.

[501scout]

First off very well thought out. I like the Idea of having a loner IFAK.

Compressed gauze PriMed in my experience is hit or miss on staying compressed. I just went through all my kits and replaced a bunch of it that had expanded. Tac Med Solutions Z pack's are good, however I replaced all mine with North American Rescue S rolled gauze. I guess they are probably equal.

Tourniquet's are a must. Rather if its the SOF-T, CAT, Swat, or whatever something is better then nothing. If you are unable to get one of those due to price, Muslim dressings(AKA the Cravat) will work and the only thing you really need is something sturdy enough to use as a windless.

The biggest thing I recommend is not going above your means. If you are expecting to get shot and enduring a sucking chest wound by all means get a Asherman, or Bolin chest seal but if not then the wrapper off your Izzy dressings will work as a make shift chest seal with duct tape on 3 sides. Plastic wrap works well too.

Suture kits are a cool item to have if you know how to properly suture and irrigate a wound. Other wise, you can cause serious damage or even death.

EMT-B classes are offered at a lot of community collages, thats actually how I got mine. Just be willing to make the time to study. I took a First Responder class first which actually had the same instructors for the B class. It was a good refresher for me and helped pave the way for EMT-B.

[Darxus]

First off very well thought out. I like the Idea of having a loner IFAK.

Huh, thanks. I didn't expect nearly so pleasant a response.

And yeah, I kept thinking about the frequent question of "How many people and what time period is this FAK for?" Well, just me, and forever, but I'll often also have my girlfriend around... hey, I should toss more gauze in her pack.

Compressed gauze PriMed in my experience is hit or miss on staying compressed. I just went through all my kits and replaced a bunch of it that had expanded. Tac Med Solutions Z pack's are good, however I replaced all mine with North American Rescue S rolled gauze. I guess they are probably equal.

Yeah, same dimensions again, and the packaging definitely looks more durable than PriMed. That consistency is nice. Added that to the wiki page on Kerlix, which I'm scheming to one day rename to gauze (with a proper redirect, of course).

Tourniquet's are a must. Rather if its the SOF-T, CAT, Swat, or whatever something is better then nothing. If you are unable to get one of those due to price, Muslim dressings(AKA the Cravat) will work and the only thing you really need is something sturdy enough to use as a windless.

Yeah, I think I've decided to get a couple. I'm looking into a man-purse or maybe a Maxpedition waist pouch, so I can EDC a few more things (tourniquet, izzy, emergency poncho, fishing hook + line, paracord, duct tape). North American Rescue Combat Application Tourniquet seems like the best. Sure is pricy, but I think that's the one I'll get unless you folks recommend otherwise.

$30 + free shipping from Amazon, better than rescue-essentials.com's $35 + shipping.

Surely you meant "muslin", not "Muslim"? "NSN 6510-00-201-1755: Muslin Bandage, ACU Pattern". "...a loosely-woven cotton fabric...."

The biggest thing I recommend is not going above your means. If you are expecting to get shot and enduring a sucking chest wound by all means get a Asherman, or Bolin chest seal but if not then the wrapper off your Izzy dressings will work as a make shift chest seal with duct tape on 3 sides. Plastic wrap works well too.

My means are not really a problem. Just cost / weight / bulk justification.

Wow, plastic sheet with duct tape on three sides makes so much sense for treating a sucking chest wound, thanks. What's the advantage of the Asherman or Bolin chest seals, just speed? Or maybe reducing bleeding more?

Suture kits are a cool item to have if you know how to properly suture and irrigate a wound. Other wise, you can cause serious damage or even death.

Thanks. I think I'll get a couple, and see what I can learn.

EMT-B classes are offered at a lot of community collages, thats actually how I got mine. Just be willing to make the time to study. I took a First Responder class first which actually had the same instructors for the B class. It was a good refresher for me and helped pave the way for EMT-B.

[/quote]
Yeah. Scary.

Thanks for the feedback.

[Medic Mentor]

I would beg you to not worry about suturing right now. Perhaps focus on irrigation and packing wounds. Use of steri strips with Benzoin Tincture is very very effective. Mastisol is better that Benzoin. Also you can get stapler cheap and that is awesome, but unless you clean a wound thoroughly is critical.

Syringe with pressure irrigation. A quart of water with a pad yes betadine pad in a quart of tap water is superb with pressure irrigation. Last couple of squirts thoroughly irrigate the betadine tinged fluid out.


TQ--and a 25 gm Quick Clot sponge is enough to stop a major bleed. SWAT T you can use as the pressure bandage over a wad of guaze on top of the quick clot sponge---hell duct tape and a t shirt is awesome. Consider vacuum packing a bunch of non sterile guaze---makes it seriously compact!!!!

[501scout]

Yeah sorry I mean't Muslin. As far as the Chest seals go, they are actually made for sucking chest wounds. Stronger adhesive and just purpose driven. The army actually thought just to use the wrapper off a dressing before the Bolin, or Asherman existed. Now don't get me wrong the ACS and BCS are much faster to use and will stick with blood better then duct tape.

If you just want to be able to carry a CAT on your belt. I used a 1inch thick elastic band and just ran it through my belt and slid the cat through it on its side down range. it worked very well and allowed me just to carry the CAT on me pretty much every place I went when I did not
wear all my kit. I have a few older CAT's Brand new in wrapper if your interested PM me and I will be willing to part with a few.

EMT-B - if you take it just be ready to study. I'm active duty Army, I am a Infantry guy and have been for 9 years. Any chance I have gotten for some type of medical training I have jumped on. Using my time and money to go to the B class was scary because I hate school, but it was so interesting to me and the interest is what drove me through that course. I after the B class it actually got my butt in gear to start taking other classes interesting and not so interesting ones. It acted as my gateway drug to get back in school.

Steri strips rock and are really easy to use. take the advice on suturing, learn how to clean a wound first.

[Medic Mentor]

Yeah sorry I mean't Muslin. As far as the Chest seals go, they are actually made for sucking chest wounds. Stronger adhesive and just purpose driven. The army actually thought just to use the wrapper off a dressing before the Bolin, or Asherman existed. Now don't get me wrong the ACS and BCS are much faster to use and will stick with blood better then duct tape.

If you just want to be able to carry a CAT on your belt. I used a 1inch thick elastic band and just ran it through my belt and slid the cat through it on its side down range. it worked very well and allowed me just to carry the CAT on me pretty much every place I went when I did not
wear all my kit. I have a few older CAT's Brand new in wrapper if your interested PM me and I will be willing to part with a few.

EMT-B - if you take it just be ready to study. I'm active duty Army, I am a Infantry guy and have been for 9 years. Any chance I have gotten for some type of medical training I have jumped on. Using my time and money to go to the B class was scary because I hate school, but it was so interesting to me and the interest is what drove me through that course. I after the B class it actually got my butt in gear to start taking other classes interesting and not so interesting ones. It acted as my gateway drug to get back in school.

Steri strips rock and are really easy to use. take the advice on suturing, learn how to clean a wound first.

Good advice. Go 25th Infantry Tropic Lightning!

[501scout]

Thanks No longer 25th though

[Medic Mentor]

I was a corpsman with 3/3 at K Bay, many many long nights in the sugar cane fields...PTA....knew a lot of great seriously great PA's with the TMCs moonlighting out at a few ER's in Hawaii.

Nothing better than seeing the Huey from MAST from Wheeler and then later the Blackhawks show up for our heat exhaustion cases on the N shore or at PTA.

[501scout]

Great times at PTA and the Kahuku's I have a few friends up in K-Bay, good dudes. We go up there every so often for ranges and what not. Thanks for your service Doc! The PA's on Scholfield are ether hit or miss, some good and some should not be allowed near other humans with any type of sharp object.

Draxus Sorry for the hijack brother.

I think this weekend I'm going to rip open a thing of kerlix, PriMed, and the S rolled and compare the 3. However I'm pretty sure they are the same length.

Sutures- I have had 3 reconstructive surgery's on both feet in the last year and a half. over 100 staples and up wards of 100 plus stitches. Before they could cast me they had to take everything out with in 2 weeks of surgery and then they used the stri strips. IMHO they held just as well and held for 6 to 8 weeks with out being replaced, no ill side affects from leaving them on, unlike sutures and staples which can be grown in or around and be a pain to remove, plus I have two rows of extra scars along each incision from the staples and sutures. I have a shit ton of sutures in my home kit but, in my Ifaks just steri strips. I'm also sure that if you are doing self aid it will be easier to use the strei's as opposed to jamming a needle throw your skin with out lidocaine.

[Jamie]

Howdy!

Bravo on the IFAK and this discussion so far...

I spent a lot of time reading about FAKs in this forum when I first joined ZS, and for a while I carried metric crapton of (what for me turns out to be) unnecessary 1st-aid materials (my hiking/paddling/camping trips seldom result in sucking chest wounds).

I go camping (either solo or with a group) every month, and based on my experiences have dropped the stuff that I never use, and reduced the stuff that I seldom use (although I still feel capable of dealing most any trauma I could encounter on the trail). The end result is the kit shown below, which is good for all of the hiking/paddling/winter/summer trips that I do. If I was going longer, I would likely just bring 2 copies of this kit:

The contents of each FoodSaver FAK are:
gloves
alcohol & betadine wipes
triple antibiotic ointment
bandaids of various sizes
1"X4" wound closure strips
gauze pads
2 yards of duct-tape wrapped around a business card
2" wide self-adhesive wrap
advil, tylenol, benadryl, loperamide, naproxen, pepto, actifed, cough-drops all in a ziplock bag

Sealing it using my foodsaver makes it easier for me to do trip-planning. I know that a sealed FAK is both complete and waterproof; When I open the FAK during a trip, I can put everything in the ziplock bag that the drugs live in, and then I'll know to replace whatever I used before re-sealing for the next trip.

Jamie - nfa

[Darxus]

I think this weekend I'm going to rip open a thing of kerlix, PriMed, and the S rolled and compare the 3. However I'm pretty sure they are the same length.

Thanks. Please take pictures of the three unopened for size / shape comparison first. I know the "large" Kerlix, PriMed and S-Rolled all have the same listed dimensions, 4.5" x 4.1 yards. But I'd love to know which size Kerlix you're actually using, and how they actually compare. Maybe number of ply each - I think the only one listed is Kerlix at 6 ply.

Sutures- I have had 3 reconstructive surgery's on both feet in the last year and a half. over 100 staples and up wards of 100 plus stitches. Before they could cast me they had to take everything out with in 2 weeks of surgery and then they used the stri strips. IMHO they held just as well and held for 6 to 8 weeks with out being replaced, no ill side affects from leaving them on, unlike sutures and staples which can be grown in or around and be a pain to remove, plus I have two rows of extra scars along each incision from the staples and sutures. I have a shit ton of sutures in my home kit but, in my Ifaks just steri strips. I'm also sure that if you are doing self aid it will be easier to use the strei's as opposed to jamming a needle throw your skin with out lidocaine.

Thanks. I have been paying attention to responses on this subject. Please believe me when I say I won't use a suture unless there are no other options (no hospitals or steri-strips left). I believe it to be extremely unlikely. But this is a zombie preparedness forum

[Darxus]

I go camping (either solo or with a group) every month, and based on my experiences have dropped the stuff that I never use, and reduced the stuff that I seldom use (although I still feel capable of dealing most any trauma I could encounter on the trail).

You sure you don't want one roll of Kerlix / PriMed / Z-Pak / S-Rolled gauze (large, 4.5" x 4.1 yards) in there?

Where did you get your Betadine (povidone iodine) wipes? Having difficulty finding them for a reasonable shipped price.

I need to look into these FoodSaver type vacuum packing things. Would you buy the same one you have over again?


I ordered two SOFTT-W tourniquets, new version of the SOFT-T, without the thumb screw, and wider. viewtopic.php?f=43&t=59861 seems to cover the subject pretty well, and I think says the SOFT-T is the best, predating the existence of the SOFTT-W. Also ordered a 25g (9cm x 9cm) QuikClot sport. And a nasopharyngeal airway. The answer to my question about when nasopharyngeal airways are useful seems to be: It's common for a person's tongue to get in the way of breathing, and this will fix that in a way that makes your hands free to deal with other problems (bleeding, other people). I guess I'd still like to know how often this kind of thing (use of an airway) comes up for people like EMTs.

I still haven't ordered any sutures. But I still want some. This seems like pretty good info on suture preparation:
http://apps.med.buffalo.edu/procedures/ ... s.asp?p=17

1. Mechanical cleansing: surgical scrub brush, soap and water
2. Mechanical Cleansing: normal saline irrigation using a 30- or 60-cc syringe with an 18- or 20-gauge needle to develop pressure. Use 100 cc of saline for each cm of wound
3. Chemical cleansing: Betadine, Savlon, or Hibiclens
4. Freshen wound edges if necessary with scalpel or scissors

I found the "100 cc of saline for each cm of wound" for irrigation the most interesting. Scrubbing an open wound with a scrub brush, soap, and water, sounds like it would be... fascinating.

Syringe with pressure irrigation. A quart of water with a pad yes betadine pad in a quart of tap water is superb with pressure irrigation. Last couple of squirts thoroughly irrigate the betadine tinged fluid out.

I couldn't read that at all the first time, but I saw somebody else say basically the same thing and I figured it out. A betadine (povidone-iodine) wipe diluted in water makes the water the perfect thing to irrigate a wound with. I also read that yes, tap / filtered surface water is fine, doesn't need to be sterile.

[Jamie]

I go camping (either solo or with a group) every month, and based on my experiences have dropped the stuff that I never use, and reduced the stuff that I seldom use (although I still feel capable of dealing most any trauma I could encounter on the trail).

Q1 - You sure you don't want one roll of Kerlix / PriMed / Z-Pak / S-Rolled gauze (large, 4.5" x 4.1 yards) in there?

Q2 - Where did you get your Betadine (povidone iodine) wipes? Having difficulty finding them for a reasonable shipped price.

Q3 - I need to look into these FoodSaver type vacuum packing things. Would you buy the same one you have over again?

A1 - Nope, I've got enough to cover most needs, and in an emergency I'd use some clothing or a sock over the gauze I do have to pack a serious bleed.

A2 - I got the wipes from my local Kinney drugstore...they had them in a 20-pack.

A3 - I got my foodsaver during a sale for under $30 shipped...I would definitely buy the same one again...it works great (although it lacks some features of the fancier ones).

Jamie

[Darxus]

Another thread finally convinced me not to buy sutures. Basically, I finally found somebody actually saying it's just safer to let it heal open. It also made me think to look up the relevant recommendation in the Army Survival Field Manual (FM 21-76), page 33, Open Wounds:

The "open treatment" method is the safest way to manage wounds in survival situations. Do not try to
close any wound by suturing or similar procedures. Leave the wound open to allow the drainage of any
pus resulting from infection. As long as the wound can drain, it generally will not become life-threatening,
regardless of how unpleasant it looks or smells.
Cover the wound with a clean dressing. Place a bandage on the dressing to hold it in place. Change the
dressing daily to check for infection.
If a wound is gaping, you can bring the edges together with adhesive tape cut in the form of a "butterfly"
or "dumbbell" (Figure 4-7).
In a survival situation, some degree of wound infection is almost inevitable. Pain, swelling, and redness
around the wound, increased temperature, and pus in the wound or on the dressing indicate infection is
present.

This quote is preceded by more info on wound cleaning, and followed with info on infected wounds. I really need to re-read this hole book some time.