med gear

[guamcurious]

i am building up a new medical bag and am wondering what everybody is carrying in their cars/ on their person as far as emergency first aid equipment? it sounds like tib/fib and femors are quite popular bones to break. from the incident list it seems like massive bleeding may also be a reaccurring theme. what else? has anyone seen anything thats worked really well?
thanks for the input
k

[No_Mind]

It would be nice to hear any paramedics views on the above question too, as sometimes field medical attention can cause more damage. In the gulf medics hate the clotting agent that is used in the field, I know you probably won't use that by any means. Maybe an advanced first aid course would be a good place to learn things as they work alongside paramedics.

Take Care

No_Mind

[Uberchris]

nicotine, valium vicodin marijuana ecstacy and alcohol...........
?????

[No_Mind]

Painkillers would be on the top of my list but would have to be careful as to monitor amounts and types of drugs administered. When something like morphine is administered in the field a big M with time and amount given is written on the persons forehead to aid medical staff.

[stitch]

The clotting agent is a sponge called "Quik Clot". I carry 2 large and 2 small in the backcountry kit. Good luck getting narcotic pain meds. Even people with certifications have a hard time obtaining them for private kits. Carry a pint of Wild Turkey just in case.

[nicknitro71]

Loaded .45 ACP, 1911 style, 10 in the clip (double stack mag), one in the throat. I can handle 11 emergency procedures with that.

[No_Mind]

The clotting agent I was referring too is a volcanic ash substance and comes in bags that are torn open and poured on they are a medics worst nightmare but do the job they are intended for!
Narcotic pain relief are almost impossible to obtain I agree and it would depend on which country/state you are from as to what you can legally carry.
I would also carry items to help in survival depending on the location, an emergency heat blanket can stop the onset of hypothermia, also something to eat may be useful if stuck somewhere waiting for rescue.

[makeitquick]

i graduate EMT school in a month, not a ton of experience, but for what its worth, here we go....

pain med's, bad idea. but i carry them on every jump. know what you have and their dosages and REMEMBER WHEN YOU TAKE IT!! It will make EMS' job less of a shit storm when they cant figure out what their pain meds are reacting badly with.

sling/swath bandages, typically used for broken shoulders/collarbones. but there is NOTHING that cannot be made out of these. i know shoulders aren't a huge injury of ours, but they can be used for bandaging other cuts, splinting broken bones, and pretty much whatever you need them to be, up to and including tourniquets. but remember the danger of those! it IS a very serious decision and you really are choosing life over limb. don't expect to keep it. thats all.

traction splints for fermurs are the shit! I used one on a car accident pt. the other day and the relief in his eyes when we finally pulled traction, honestly thought he finished in his pants. they are expensive and bulky though, so carrying them onto every jump will be incredibly cumbersome.

I have a c-spine immobilization collar that i carry too, one of the adjustable ones that can get longer/shorter depending on the build of the person. I'm not sure where to get them, but they're really cheap, $10 or so i believe.

[guamcurious]

I snagged a CT-6 traction splint from work. It is made of carbon fiber and folds into somthing the size of one of those old-school 1980's cellphones. Also have you guys seen the quikclot brand combat gauze. Its gauze impregnated with quikclot...it is supposed to cause a lot less tissue damage and doesn't get insanely hot. it also shouldn't burn the shit out of your eyes in a breeze.

[ZegeunerLeben]

>>If you have to apply a tourniquet, make sure you mark a 'T' in blood on the person's forehead afterwards. A missed tourniquet can cost someone a limb

[jools]

A few of us did a 1st aid course a year or 2 ago.
Got a mountain rescue/ wilderness guy to run one specifically for a group of BASE jumper and briefed him on what we wanted from in.

In the grand scheme the is not that much we can do but call in the pros if things are ugly. Fuck the object, make the call.

The 2 top tips are
No1. Cling film (cellophane) for holding anything in place (if you use enough) and if you remove 3 wraps from the roll it is sterile so good for open wounds and burns. It is transparent so you/paramedics can see the wound, it will not stick to the skin or wound and is light weight.

No2 is this SAM SPLINT: The gold standard in splinting.
we played with them and they are amazing, mould em to fit any limb, light weight can be x rayed hold em in place with a bit of cling film and hey presto!!
I ordered 2 the day after the course.

[mojo71]

Consider a good hook knife or trauma shears. The medics are going to cut the clothes/gear you might as well cut the gear off and stash it.

"Make it quick" is correct with the C-collar. They are cheap and it will keep the patient from moving their head/neck while waiting for the medics to arrive. It can be a hassle holding c-spine while trying to direct the medics to your location.

Be extremely careful with back and neck injuries. Do not move any patient with any neck or back pain. This patient needs a C-collar applied and be fully immobilized on a backboard. Depending on where the spinal cord is damaged and how serious, will determine if a patient is a para, quad, stops breathing, or is just sore for a while. Usually the higher up the damage the more problems the patient has. If the spinal cord is severed above C-3 the phrenic nerve is severed. (Hanging) This is the nerve that controls the diaphragm.

Morphine is a bad idea. If you administer morphine or have it in your possession you will have a lot of explaining to do. (Schedule II drug) Morphine is contraindicated with a head injury. The patient can just tuff it out until the medics arrive.

Consider a BVM (Bag Valve Mask). They are cheap and disposable. It is easier and safer to use one of these than mouth to mouth. At least have a pocket mask. Without an airway you have no patient.

Broken femur. Most compound femurs break toward the outside of the leg. If the bone breaks in, the femoral artery could be severed. If this happens you will bleed to death before the medics arrive. Do not attempt to move the patient with any type of compound femoral fracture

Okay enough of the bad stuff.

SAM splints with the cling film is a very good idea.

Consider air splints. The injured wrist or ankle needs to be immobilized, for pain relief, while transporting the patient out. A 8-12' sling can be used as a hasty litter if crossed and draped over the shoulders of two individuals. The patient can sit on the sling while being carried out.

Mueller makes an "Adjust-to-Fit" ankle brace that is rock solid. Walmart sells them. This product laces up tight and will immobilize the ankle. The ankle pain disappears with sprains and rolled ankles.

Gloves, the blue or purple ones that the medics wear. Keep a pair of two in your pocket or fanny pack along with a pressure bandage. A stack of 4x4 gauze with a pair of gloves in a zip lock bag does not take up much room. Do not touch any blood/body fluids from another individual unless you are intimate with them. Protect yourself first, it does not matter how good the friend is. He/she may not be aware of the infections they carry. Gloves are very cheap and easy to use.

Finally, take a Wilderness First Responder course. An EMT-B or P is better but unless you want to maintain the license requirements the First Responder will work. The wilderness part will help you to decide if the medics are needed ASAP or if the patient can be hiked/carried out.


This is a very good topic/thread. Keep the info coming.

[Greenmachine]

One of the best topics on either forum in a long time!!

I have a few things in my truck (saw, rope, joke 1st paid kit, etc.)
and have been meaning to put together a serious medical kit since
I am now more active so thank you all very much for the great 411.

[stitch]

you might as well cut the gear off and stash it.

If you have wads of money and enjoy paying for re-harness work, sure. Otherwise, how about just undoing the chest and leg straps.

[davo]

ok, i'm thoroughly entertained by some of the things you guys have said. Some of you do have a clue, so good on you for knowing your shit.

i'm a paramedic and do SAR and technical rescue for work. So, from previous posts:

1. Quick-clot takes training to use correctly, and has a limited couple of uncontrollable bleeds that it's used for. for example, a bad bleed from a femoral artery that's high enough to be impossible to get a tourniquet (TQ) on. i'm not going to give the procedures for using it, other than to say that without quality training you shouldn't be carrying it.

2. tourniquets are useful, but no, we don't use the patients blood to annotate their use. Use a sharpie, and hell, put a T or a TQ on their forehead with the time that it was applied also. if it's a life threatening bleed, then LEAVE IT BE... (life over limb) if you don't think you want to risk losing the limb (long transport to medical care) and the patient is stable then you may want to convert it to a Pressure Dressing. lots of sterile gauze or kerlex, wrapped tight with either more kerlex, an ace bandage, or something that will get you the right amount of pressure. (careful with ace wrap because that will become it's own TQ if wrapped tight enough.)

I agree with the other posts about having a BVM or bag valve mask, i'd add simple airway adjuncts like the NPA and OPA

a C-collar was another good idea, same with the same splints and traction device for femur breaks (if you can rule out pelvis involvement)

with the mention of drugs, don't get restricted substances that you'd get in trouble for posessing or using, even if you do feel justified, it's not worth the risk of hard jail time for being a drug dealer in the eyes of the court system. On the other hand, over the counter NSAIDs (tylenol, motrin) are fine, just know what the toxic dose is and don't get close to it. if you could get epinephrine auto-injectors and benadryl for alergic reactions that'd be another good idea.

I'd like to see every base jumper know how to apply a sling and swath, a pressure dressing, splints to the limbs, and be able to control someone's C-spine. rescue breathing and CPR would be a plus but the above basics would effectively speed up loading and transport times for when help arrives.

don't carry things that you don't know how to use correctly.

It's all fun and games until you're laying smashed up on the talus...